LAKEVIEW MEDICAL CENTER INC OF RICE LAKE: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- LAKEVIEW MEDICAL CENTER INC OF RICE LAKE (EIN 39-0837206)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-08-15
- IRS object ID
- 201842279349301774
- Schema version
- 2016v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-08-15T10:59:44-05:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 Wells Fargo Ctr 90 S 7th | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | 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 | 390837206 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEVIEW MEDICAL CENTER INC | BusinessNameLine1Txt |
| Business Name Line2 | OF RICE LAKE | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % Lisa Fenhaus-Johnson | InCareOfNm |
| Business Name Control | LAKE | BusinessNameControlTxt |
| Phone | 7152341515 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 W STOUT STREET | AddressLine1Txt |
| City | RICE LAKE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54868 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GORDON EDWARDS | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7153875511 | PhoneNum |
| Signature | 2018-08-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MONROE J GIERL | PreparerPersonNm |
| PTIN | P01413237 | PTIN |
| Phone | 6123055000 | PhoneNum |
| 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 | LAKEVIEW MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRADLEY D GROSETH CAO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 W STOUT STREET | AddressLine1Txt |
| City | RICE LAKE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54868 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $90,767,057 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LAKEVIEWMEDICAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1919 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | WE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 170 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $55,515 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,859 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $87,571,182 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $90,455,729 | CYProgramServiceRevenueAmt |
| PY Investment Income | $206,725 | PYInvestmentIncomeAmt |
| CY Investment Income | -$343,173 | CYInvestmentIncomeAmt |
| PY Other Revenue | $367,073 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $88,200,495 | PYTotalRevenueAmt |
| CY Total Revenue | $90,120,415 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,350 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $31,494,389 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $31,727,312 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $37,101,474 | PYOtherExpensesAmt |
| CY Other Expenses | $38,137,850 | CYOtherExpensesAmt |
| PY Total Expenses | $68,595,863 | PYTotalExpensesAmt |
| CY Total Expenses | $69,866,512 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $19,604,632 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $20,253,903 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $104,801,737 | TotalAssetsBOYAmt |
| Total Assets EOY | $95,082,020 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $51,744,442 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $47,220,311 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $53,057,295 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $47,861,709 | NetAssetsOrFundBalancesEOYAmt |
| Mission | We enrich lives to create healthy communities through accessible, affordable, compassionate health care. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $55,962,217 | ExpenseAmt |
| Grant | $1,350 | GrantAmt |
| Revenue | $90,455,729 | RevenueAmt |
| Desc | Lakeview Medical Center Inc. of Rice Lake is a not-for-profit 40-bed community hospital located in Rice Lake, Wisconsin that provides medical, surgical, emergency, outpatient, dialysis, ambulance, oncology, hospice and home health services. | Desc |
| Total Program Service Expenses | $55,962,217 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 55 | IRPDocumentCnt |
| IRP Document W2 G | 13 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| 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 | Lisa Fenhaus-Johnson | PersonNm |
| Phone | 7152215339 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 N Oak Avenue | AddressLine1Txt |
| City | Marshfield | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54449 | 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 | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Brittany Nielsen | |||||||||
| Secretary | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Carol Hakala | |||||||||
| Vice Chair | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Peter Neal MD | |||||||||
| Chair (through Nov 2016) | 41.0 | 0.0 | Yes (X) | Yes (X) | $0 | $329,529 | $46,400 | ||
| Sue Tindell | |||||||||
| Chair | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Bob Berg | |||||||||
| Board Member | 1.0 | 40.0 | Yes (X) | $0 | $0 | $0 | |||
| Brenda Kupferschmidt | |||||||||
| Board Member | 1.0 | 40.0 | Yes (X) | $0 | $0 | $0 | |||
| Craig Fowler | |||||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Dan Ringwelski | |||||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Mark Nymo MD | |||||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Neelakantan Namboodiri MD | |||||||||
| Board Member | 1.0 | 40.0 | Yes (X) | $0 | $318,172 | $51,077 | |||
| Peter Cochrane MD | |||||||||
| Board Member | 1.0 | 40.0 | Yes (X) | $0 | $375,574 | $47,400 | |||
| Scott Polenz | |||||||||
| Board Member | 1.0 | 40.0 | Yes (X) | $0 | $226,707 | $51,104 | |||
| Tom Lundquist MD | |||||||||
| Board Member | 1.0 | 40.0 | Yes (X) | $0 | $209,984 | $53,451 | |||
| Jackie Klein | |||||||||
| CFO | 40.0 | 0.0 | Yes (X) | $0 | $187,240 | $52,525 | |||
| Bradley Groseth | |||||||||
| CAO | 40.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Daniel Ramsey | |||||||||
| MCHS COO | 1.0 | 40.0 | $0 | $763,197 | $27,953 | Yes (X) | |||
| Gordon Edwards | |||||||||
| MCHS CFO | 1.0 | 40.0 | $0 | $560,037 | $26,618 | Yes (X) | |||
| Jerard Jensen | |||||||||
| MCHS General Counsel | 1.0 | 40.0 | $0 | $547,501 | $25,224 | Yes (X) | |||
| Julie Brussow | |||||||||
| MCHS Health Plan CEO | 1.0 | 40.0 | $0 | $452,735 | $45,701 | Yes (X) | |||
| Narayana Murali MD | |||||||||
| MCHS Chief Strategy Officer | 1.0 | 40.0 | $0 | $828,964 | $57,850 | Yes (X) | |||
| Susan Turney MD | |||||||||
| MCHS CEO | 1.0 | 40.0 | $0 | $1,663,671 | $200,630 | Yes (X) | |||
| Ned Wolf | |||||||||
| Former LMC CEO | 1.0 | 40.0 | $0 | $387,947 | $56,100 | Yes (X) | |||
| Cindy Arts-Strenke | |||||||||
| Former LMC COO | 1.0 | 40.0 | $0 | $211,433 | $42,676 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,062,691 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $784,709 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Sightpath Medical LLC | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 204253 | AddressLine1Txt |
| City | Dallas | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75320 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Medical services | ServicesDesc |
| Compensation | $352,925 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $7,859 | GovernmentGrantsAmt |
| Total Contributions | $7,859 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $87,930,229 | $87,930,229 |
| INTERCOMPANY REVENUE | 621110 | $1,678,886 | $1,678,886 |
| CAFETERIA REVENUE | 621110 | $435,542 | $435,542 |
| MISC OTHER OPERATING REVENUE | 621110 | $323,749 | $323,749 |
| WELLNESS REVENUE | 621110 | $87,323 | $87,323 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $90,455,729 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $170,230 | TotalRevenueColumnAmt |
| Exclusion | $170,230 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $133,239 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $133,239 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $513,403 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$513,403 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$513,403 | TotalRevenueColumnAmt |
| Exclusion | -$513,403 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $90,120,415 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $90,455,729 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$343,173 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,350 | TotalAmt |
| Program Services | $1,350 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $322,359 | TotalAmt |
| Management And General | $322,359 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,813,042 | TotalAmt |
| Program Services | $19,122,484 | ProgramServicesAmt |
| Management And General | $4,690,558 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,186,549 | TotalAmt |
| Program Services | $1,762,840 | ProgramServicesAmt |
| Management And General | $423,709 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,750,181 | TotalAmt |
| Program Services | $2,999,237 | ProgramServicesAmt |
| Management And General | $750,944 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,655,181 | TotalAmt |
| Program Services | $1,360,900 | ProgramServicesAmt |
| Management And General | $294,281 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,975,022 | TotalAmt |
| Program Services | $1,536,201 | ProgramServicesAmt |
| Management And General | $438,821 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30 | TotalAmt |
| Program Services | $30 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,171,490 | TotalAmt |
| Program Services | $917,244 | ProgramServicesAmt |
| Management And General | $254,246 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,969,674 | TotalAmt |
| Program Services | $472,643 | ProgramServicesAmt |
| Management And General | $1,497,031 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $965,507 | TotalAmt |
| Program Services | $858,078 | ProgramServicesAmt |
| Management And General | $107,429 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $221,284 | TotalAmt |
| Program Services | $214,466 | ProgramServicesAmt |
| Management And General | $6,818 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,444,696 | TotalAmt |
| Program Services | $1,444,696 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,487,592 | TotalAmt |
| Program Services | $4,487,592 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $18,245,884 | $18,154,757 | $91,127 |
| I/C Purchased Services | $4,940,735 | $4,940,735 | |
| WI MEDICAID ACCESS TAX | $1,471,435 | $1,471,435 | |
| Equipment Repairs | $1,078,486 | $1,064,117 | $14,369 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,015 | TotalAmt |
| Program Services | $94,147 | ProgramServicesAmt |
| Management And General | $71,868 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,866,512 | TotalAmt |
| Program Services | $55,962,217 | ProgramServicesAmt |
| Management And General | $13,904,295 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,798,026 | BOYAmt |
| EOY | $14,361,760 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,811,044 | BOYAmt |
| EOY | $1,786,354 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,728,774 | BOYAmt |
| EOY | $10,718,436 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,143,262 | BOYAmt |
| EOY | $993,023 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $324,600 | BOYAmt |
| EOY | $201,279 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $102,937,142 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $38,992,683 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,532,857 | BOYAmt |
| EOY | $63,944,459 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,432 | BOYAmt |
| EOY | $19,452 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,448,742 | BOYAmt |
| EOY | $3,057,257 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,801,737 | BOYAmt |
| EOY | $95,082,020 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,374,616 | BOYAmt |
| EOY | $1,636,305 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,821,290 | BOYAmt |
| EOY | $45,070,821 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $548,536 | BOYAmt |
| EOY | $513,185 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,744,442 | BOYAmt |
| EOY | $47,220,311 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,057,295 | BOYAmt |
| EOY | $47,861,709 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,057,295 | BOYAmt |
| EOY | $47,861,709 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,801,737 | BOYAmt |
| EOY | $95,082,020 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $20,253,903 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$25,449,489 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $4,503,454 | OtherCostOrOtherBasisAmt |
| Book Value | $4,503,454 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $70,930,710 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,819,494 | DepreciationAmt |
| Book Value | $51,111,216 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $360,145 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,728 | DepreciationAmt |
| Book Value | $351,417 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $23,733,542 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,632,096 | DepreciationAmt |
| Book Value | $6,101,446 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $3,409,291 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,532,365 | DepreciationAmt |
| Book Value | $1,876,926 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $63,944,459 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED COMPENSATION | Desc |
| Amt | $513,185 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $513,185 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Form Sch D Part X Line 2 | FormAndLineReferenceDesc |
| Explanation | The organization applies Financial Accounting Standards Board (FASB) accounting standards codification (ASC) topic 740, Income taxes (ASC 740), which clarifies the accounting for uncertainty in income taxes recognized in a company's financial statements. ASC 740 prescribes a more-likely than-not recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken. Under ASC 740, tax positions will be evaluated for recognition, derecognition, and measurement using consistent criteria and will provide more information about the uncertainty in income tax assets and liabilities. Based on an analysis, it was determined that the application of ASC 740 had no material effect on the organization at September 30, 2017. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $533,951 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $533,951 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00760 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,821,939 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,065,291 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,756,648 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05380 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,355,890 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,065,291 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,290,599 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06140 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $387,215 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $99,083 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $288,132 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00410 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $166,031 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $166,031 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,271,739 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,760,006 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,511,733 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02160 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,881 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $17,881 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,842,866 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,859,089 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,983,777 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02840 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,198,756 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,924,380 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,274,376 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08980 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $477,675 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $24,772,335 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $27,299,694 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,527,359 | 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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | None | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEVIEW MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 W STOUT STREET | AddressLine1Txt |
| City | RICE LAKE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54868 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 82 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEVIEW MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.lakeviewmedical.com | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.lakeviewmedical.com | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Supplemental Information | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Supplemental Information | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Supplemental Information | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form Sch H Part V Line 5 | Lakeview Medical Center Inc. of Rice Lake completed its second CHNA in partnership with the Barron County Health Department, the Wisconsin Department of Health, and the other healthcare systems in the community. In addition to analyzing demographic information, the group collected secondary data through both an online and paper survey concerning disease, death, disability, injury and community opinions. The survey was translated to Somali and Spanish to include feedback from underserved populations in the county. |
| Form Sch H Part V Line 6a | The CHNA was conducted with the following hospital facility(s): Mayo Clinic Health Systems Cumberland Clinic and Hospital |
| Form Sch H Part V Line 6b | The CHNA was conducted with the following non-hospital facility(s): Barron County Health Department Wisconsin Department of Health |
| Form Sch H Part V Line 11 | Upon completion of the CHNA, Lakeview Medical Center developed a Hospital Implementation Strategy (HIS) to impact the priorities that were identified. The identified priorities were alcohol and other drug abuse, chronic disease management and mental health issues. This includes goals, objectives and action plans for the priorities of chronic disease prevention, alcohol and other drug abuse and mental health issues. As part of the HIS related to chronic disease, Lakeview Medical Center offered a free screening for community members to help identify those at risk of diabetes and to educate them on what their screening numbers mean to their health. The National Diabetes Prevention Program was offered to those community members found to be at risk for diabetes. As part of the HIS related to mental health, magnets and fliers with the mental health crisis line information have been developed and provided to schools, nonprofit organizations, law enforcement and various business and industrial worksites. Another strategy for the mental health priority is to establish and offer a Mental Health First Aid program to the community. Lakeview Medical Center has worked through the year to identify a facilitator to implement the program and was successful. It will be offered to all staff and free community seminars will be set. As part of the HIS related to alcohol and other drug abuse, Lakeview Medical Center continues to work with the Barron County Sherriff's Department on promoting the use of the driving simulator in order to reduce driving deaths due to drinking and driving. Lakeview Medical Center is also partnering with the Barron County Sherriff's Department on a Drug Take-back campaign. Lakeview Medical Center dedicated a story on the importance of disposing of prescription medication properly in drop boxes in its most recent Community Benefit Annual Report. Magnets listing all of the area boxes were printed and inserted into the reports that were distributed to 41,000 households in the area. Another component of the campaign is to produce a video with the Sherriff as a spokesperson that will convey the importance of using the drop boxes and be shown in the local movie theater. |
| Form Sch H Part V | Line 16 a-c The Financial Assistance Policy (including the Plain Language Summary) and the Financial Assistance Application are available at this URL: https://www.marshfieldclinic.org/patient-resources/billing/financial- assistance |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form Sch H Part I Line 3c | An individual's eligibility for financial assistance is based on income as compared with federal poverty guidelines. Other eligibility factors include: asset limitations, insurance status and residency. Account balance is considered for medical indigence eligibility. Form Sch H Part I Line 7 Explanation of costing methodology used for calculating Line 7 table:Amounts calculated in Part I, Line 7 are determined based on a cost-to-charge ratio. Other benefits are determined based on the direct and indirect costs (where allocated) associated with a program net of earned revenue. |
| Form Sch H Part III Line 2 | Bad debt expense is reported at cost using a cost-to-charge ratio. |
| Form Sch H Part III Line 3 | ALL ORGANIZATIONS WITHIN MARSHFIELD CLINIC HEALTH SYSTEM (MCHS) DESIRE TO IDENTIFY A PATIENT'S NEED FOR FINANCIAL ASSISTANCE AS QUICKLY AS POSSIBLE. THE DETERMINATION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON AN APPLICATION, WRITTEN AND ORAL COMMUNICATION, AND OTHER DOCUMENTATION USED TO CONDUCT AN INDIVIDUALIZED ASSESSMENT AND VALIDATE THE PATIENT OR GUARANTOR'S CIRCUMSTANCES USING A VARIETY OF CRITERIA. FOR THESE REASONS, THERE IS NO ESTIMATED DOLLAR AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. |
| Form Sch H Part III Line 4 | Patients' receivables are reduced by an allowance for uncollectible accounts. In evaluating the collectability of patients' accounts receivable, the System analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for uncollectible accounts. For receivables associated with services provided to patients who have third-party coverage, the System analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the System 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 difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible accounts. |
| Form Sch H Part III Line 8 | The Medicare shortfall attributed to identified subsidized health services are included as community benefit in the current year. These services include ambulance, home care and hospice and dialysis. The Medicare allowable costs as reported on the Medicare Cost Report do not fully capture the actual costs of providing these services that are essential to various underserved populations in the community. |
| Form Sch H Part III Line 9b | The organization has a billing and collection policy which sets forth collection practices for patients who are known to be eligible or presumed to be eligible for financial assistance under the financial assistance policy. Multiple measures are taken to communicate the availability of financial assistance and determine whether a patient is financial assistance eligible before pursuing extraordinary collection actions. |
| Form Sch H Part VI Line 2 | Lakeview Medical Center, Inc. (LMC) of Rice Lake completed its second Community Health Needs Assessment (CHNA) in partnership with the Barron County Health Department and the following organizations: Wisconsin Department of Health, Marshfield Clinic, Mayo Clinic Health Systems and Cumberland Clinic and Hospital. The committee has adopted the following name for the initiative: Thrive Barron County (Thrive BC), Growing Together in Health. Thrive BC will work to engage community members and organizations to focus resources and develop and strengthen partnerships to establish sustainable, safe and healthy communities. The vision is that community members and organizations work together to improve the quality of life for everyone in Barron County. In order to achieve this, Thrive BC will meet regularly and systematically collect, assemble, analyze and make available information related to the health of the community. The CHNA was reviewed by LMC's board of directors and subsequently published on LMC's public website. Paper copies are available to anyone requesting a printed version at the hospital. Print copies are available by request via an electronic request special URL publicized in LMC's community benefit report. This report is mailed to over 40,000 households. Along with analyzing demographic information, the coalition has collected secondary data through both online and paper surveys concerning disease, death, disability, injury and community opinions. The survey was translated to Somali and Spanish to include feedback from underserved populations in the county. Also targeted for feedback in this CHNA was the inmate population in the Barron County jail. Over 900 responses out of the county population of 45,445 were completed. Along with the secondary data, the committee analyzed state and national data based on the 12 Wisconsin health priorities. This data was presented to 50 community members, leaders and experts. At a September 30, 2015 meeting, attendees came together to review health priority assessment data and accomplishments. From 201 priorities selected, the top 3 health priorities for Barron County were identified as: (1) Alcohol and Other Drug Abuse, (2) Mental Health Issues and (3) Chronic Disease. LMC has representatives actively working on the Thrive BC committees focused on alcohol and other drug abuse and has representatives serving on the Thrive BC steering committee. Upon completion of the CHNA, LMC completed a Hospital Implementation Strategy (HIS) to impact the priorities identified. The LMC board of directors approved the HIS at the August 25, 2016 board meeting and continues to monitor LMC's community health implementation plan. As part of the HIS related to chronic disease, LMC along with Thrive BC business partners offered a free health screening called Know Your Numbers. This screening enabled community members to help identify risk of diabetes and educated them in regard to what their screening results meant to their health. In the current year LMC conducted 181 free screenings out of a total 671 completed collectively. Of the 181 participants screened at LMC, 33% were found to be at risk for developing diabetes. Health education was then offered to participants falling in the at risk category. Along with the CHNA, LMC assesses the health care needs of the communities and areas it serves by reviewing local demographics and trends in patient service utilization to determine which services could and should be made available to the community in a cost-effective manner. |
| Form Sch H Part VI Line 3 | Patient Assistance Center counselors assist individuals with identifying, referring and/or applying for public, private or charitable resources for which the patient may qualify. Counselors are available via phone and in person to assist individuals with Financial Assistance. Information on the Marshfield Clinic Health System (MCHS) Financial Assistance Policy is posted in hospital registration and admitting locations and in the hospital emergency department. Financial assistance information is printed on monthly billing statements and incorporated into other communications in order to widely publicize the availability of financial assistance, as described in the MCHS Billing and Collection Policy. The MCHS Financial Assistance Policy (including the Plain Language Summary), the Financial Assistance Application and the Billing and Collection Policy are available in English, Spanish, Hmong and any other language that is the primary language spoken by the lesser of 1,000 individuals or 5% of the population of the service area. The MCHS Financial Assistance Policy (including the Plain Language Summary), the Financial Assistance Application and the Billing and Collection Policy may be obtained free of charge: on the hospital website, in person, from financial counselors, by phone and by mail. |
| Form Sch H Part VI Line 4 | The primary service area for Lakeview Medical Center (LMC) encompasses all persons living with a 30 to 40 mile radius of the hospital. Some of the communities included in this area are: Rice Lake, Cameron, Barron, Birchwood, Ladysmith, Cumberland, Chetek and Spooner, Wisconsin among many others. LMC provides a significant portion of its patient services to beneficiaries of the Medicare and Medical Assistance programs. Medicare and Medical Assistance patients accounted for approximately 66% of LMC's gross patient revenue for the year. |
| Form Sch H Part VI Line 5 | Lakeview Medical Center (LMC) furthers its exempt purpose by promoting the health of the community with the following: LMC partnered with Barron County Public Health, along with the county's 2 other healthcare systems in the Barron County community health improvement process to identify local health concerns and address local health priorities. The information gathered from this process was used to identify and prioritize community health issues and needs. LMC has focused on education efforts through health programs and community screenings based on this information. LMC's specific efforts have provided programs to support the Barron County community coalition to support the priorities identified in the CHNA: Alcohol and Other Drug Abuse, Chronic Disease and Mental Health Issues. The Sexual Assault Nurse Examiner (SANE) program at LMC supports the community effort to address the crime of sexual assault by establishing a process for accurate evidence collection and by providing support for sexual assault survivors. LMC has a booth at a local farmer's market that has 200-300 attendees each week. The LMC booth offers health-related information and/or screening related to a different topic each week. LMC administered 175 free blood pressure screenings, 25 flu shots, 20 balance screenings and offered the Hiding in Plain Sight Drug Education room in addition to the other activities over the 18 week span that the farmer's market was active. This year the focus was on living a healthy lifestyle which included healthy recipes and food samples, a driving simulator and balance testing. 50 Plus is a free wellness event for those over 50 years old. The event offers a variety of health screenings, community resources, educational presentations and entertainment. This event is coordinated by a coalition of community agencies led by LMC. An LMC representative is a member of the Rice Lake Chamber of Commerce business and education committee. This committee focuses on improving business opportunities and education in Rice Lake. An LMC representative is a member of the Rice Lake United Way Coalition serving the community by issuing community improvement grants. An LMC representative is a member of the Community Connections to Prosperity Coalition. The mission of the coalition is to help individuals, organizations and agencies understand and deeply appreciate the immense power of poverty. The goals of the coalition are to: - Educate businesses and the community regarding issues with poverty in Barron County and provide training to individuals who will mentor those in poverty - Identify those in poverty and determine what is needed to move them forward - Provide pathways to skills training, resources and personal connections to assist people in poverty to move towards prosperity - Connect newly trained individuals with employers and maintain ongoing coaching contact. An LMC representative also facilitates a mental health action team that was developed from the coalition. The mission of this action team is to educate and reduce stigma of mental illness, which will increase awareness and reduce the potentially debilitating consequences of mental illness (including poverty, substance abuse, homelessness and many chronic health conditions). The goals of this action team are to: - Coordinate and/or facilitate evidence-based suicide prevention practices - Promote zero suicide principles and practices with health care providers and health care systems - Work with local school districts to understand and/or reduce youth suicides and suicidal thoughts/behaviors (specifically through the promotion of the "End the Silence" program). Another LMC initiative to address health risks related to chronic disease is their Hang On Challenge. This is a community challenge to assist community members to lose or maintain their weight during the holiday season. 210 participants were able to lose a total of 225 pounds during this 9-week challenge. LMC health promotion staff provided participants with weekly nutrition and exercise education handouts. The hospital offers free radiology and lab services to the free clinic serving the underserved population in the area. The health and wellness center is the only one in the area offering community members the opportunity to exercise while being supervised by medically trained staff. LMC financially supports the operating cost as expenses exceed revenue. Free blood pressure screenings are provided to community members on a monthly basis at the following locations: Rice Lake Senior Center, LMC Health and Wellness Center and the LMC Cafe. LMC is committed to support the training of future medical professionals to impact projected medical staff shortfalls. Starting in January 2016, LMC started offering the National Diabetes Prevention Program. This program has been approved by the Center for Disease Control (CDC) and has been proven to be successful in the prevention of diabetes. Facilitators are trained at LMC and teach the skills that participants need to lose weight, be more physically active and to manage stress. The program consists of 16 weekly sessions aimed at helping participants maintain healthy lifestyle changes. Two main goals of the program are weight loss at 7% and achievement of 150 minutes of exercise each week. In the current year, 6 groups with a total of 72 participants completed the program. Of the 87 participants, 90% stayed with the program through completion. Results indicated 7% weight loss in 85% of those that finished the program with 95% achieving 150 minutes of exercise per week. |
| Form Sch H Part VI Line 6 | Marshfield Clinic Health System, Inc. (MCHS) was incorporated in October 2012 as part of a prospective reorganization of Marshfield Clinic and its affiliated entities. In particular, MCHS was formed to serve as a parent entity for a reorganized healthcare system that includes Marshfield Clinic, Inc., Lakeview Medical Center, Inc. of Rice Lake and Security Health Plan of Wisconsin, Inc. Marshfield Clinic, founded in 1916, is a not-for-profit group medical practice engaged in providing healthcare, healthcare education, medical research and community service. Security Health Plan, a nonstock, not-for-profit health maintenance organization was established to provide prepaid medical care to individual and group subscribers. Lakeview Medical Center is a not-for-profit, 40-bed community hospital located in Rice Lake, Wisconsin. MCHS Hospitals, Inc. was incorporated in December 2015 as a nonprofit, nonstock corporation to facilitate the expansion of MCHS hospital services through acquisition or construction. The hospitals are operated by MCHS Hospitals in collaboration with Marshfield Clinic. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Substantiation Required | false | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (true) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | Yes (true) | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (true) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (true) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 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 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Peter Neal MD | |||||||||||||
| Chair (through Nov 2016) | $0 | $321,320 | $0 | $0 | $0 | $8,209 | $0 | $30,062 | $0 | $17,583 | $0 | $377,174 | |
| Neelakantan Namboodiri MD | |||||||||||||
| Board Member | $0 | $315,160 | $0 | $0 | $0 | $3,012 | $0 | $30,062 | $0 | $22,260 | $0 | $370,494 | |
| Peter Cochrane MD | |||||||||||||
| Board Member | $0 | $372,562 | $0 | $0 | $0 | $3,012 | $0 | $30,062 | $0 | $18,583 | $0 | $424,219 | |
| Scott Polenz | |||||||||||||
| Board Member | $0 | $220,547 | $0 | $0 | $0 | $6,160 | $0 | $30,062 | $0 | $21,991 | $0 | $278,760 | |
| Tom Lundquist MD | |||||||||||||
| Board Member | $0 | $195,674 | $0 | $10,709 | $0 | $3,601 | $0 | $30,062 | $0 | $24,257 | $0 | $264,303 | |
| Cindy Arts-Strenke | |||||||||||||
| Former LMC COO | $0 | $204,156 | $0 | $0 | $0 | $7,277 | $0 | $28,968 | $0 | $14,408 | $0 | $254,809 | |
| Jackie Klein | |||||||||||||
| CFO | $0 | $185,950 | $0 | $0 | $0 | $1,290 | $0 | $28,178 | $0 | $25,136 | $0 | $240,554 | |
| Ned Wolf | |||||||||||||
| Former LMC CEO | $0 | $290,061 | $0 | $0 | $0 | $97,886 | $0 | $30,062 | $0 | $27,257 | $0 | $445,266 | |
| Daniel Ramsey | |||||||||||||
| MCHS COO | $0 | $679,296 | $0 | $35,000 | $0 | $48,901 | $0 | $2,080 | $0 | $27,118 | $0 | $792,395 | |
| Gordon Edwards | |||||||||||||
| MCHS CFO | $0 | $479,521 | $0 | $51,000 | $0 | $29,516 | $0 | $2,080 | $0 | $25,783 | $0 | $587,900 | |
| Jerard Jensen | |||||||||||||
| MCHS General Counsel | $0 | $498,864 | $0 | $25,000 | $0 | $23,637 | $0 | $2,080 | $0 | $24,389 | $0 | $573,970 | |
| Julie Brussow | |||||||||||||
| MCHS Health Plan CEO | $0 | $421,611 | $0 | $20,910 | $0 | $10,214 | $0 | $30,062 | $0 | $16,884 | $0 | $499,681 | |
| Narayana Murali MD | |||||||||||||
| MCHS Chief Strategy Officer | $0 | $711,628 | $0 | $97,500 | $0 | $19,836 | $0 | $30,062 | $0 | $29,033 | $0 | $888,059 | |
| Susan Turney MD | |||||||||||||
| MCHS CEO | $0 | $1,105,202 | $0 | $319,500 | $0 | $238,969 | $0 | $181,292 | $0 | $20,583 | $0 | $1,865,546 | $120,700 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form Sch J Part I Line 1 | The organization may occasionally reimburse or provide a housing allowance for key executives in order to assist with relocating to the area. The organization may also contribute to or reimburse for health and social club dues as deemed necessary in order to support a business need. Form Sch J Part I Line 3 The Marshfield Clinic Health System's (MCHS) independent compensation committee (the "committee") has final authority for approving compensation and benefits of all "disqualified persons" employed by any of the organizations in the system. Compensation to the organization's CEO/Executive Director was paid by related party Marshfield Clinic Health System. The committee uses combinations of the following to evaluate compensation: compensation committee, independent compensation consultant, compensation survey or study, approval by the board or compensation committee, and written employment contracts. |
| Form Sch J Part I Line 4b | 457(f) Plan Susan Turney, MD - $151,230 Ned Wolf - $70,909 |
| Form Sch J Part I Line 5a & 5b | SEVERAL INDIVIDUALS MAY RECEIVE INCENTIVE COMPENSATION BASED ON A VARIETY OF FACTORS, INCLUDING NOT ONLY FINANCIAL MEASURES SUCH AS REVENUE GROWTH OR EARNINGS, BUT ALSO QUALITY, SERVICE, MARKET EXPANSION, COMMUNITY & EMPLOYEE ENGAGEMENT, AND OTHER OUTCOMES OR EXPECTATIONS SET BY THE BOARD AND/OR CEO. ANY PERFORMANCE BONUS IS SUBJECT TO REVIEW BY THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE FOR REASONABLENESS. |
| Form Sch J Part I Line 6a & 6b | SEVERAL INDIVIDUALS MAY RECEIVE INCENTIVE COMPENSATION BASED ON A VARIETY OF FACTORS, INCLUDING NOT ONLY FINANCIAL MEASURES SUCH AS REVENUE GROWTH OR EARNINGS, BUT ALSO QUALITY, SERVICE, MARKET EXPANSION, COMMUNITY & EMPLOYEE ENGAGEMENT, AND OTHER OUTCOMES OR EXPECTATIONS SET BY THE BOARD AND/OR CEO. ANY PERFORMANCE BONUS IS SUBJECT TO REVIEW BY THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE FOR REASONABLENESS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 Part VI Line 6 | Marshfield Clinic Health System, Inc. (a Wisconsin nonstock, nonprofit organization described in code section 501(c)(3)) is the sole member of Lakeview Medical Center Inc. of Rice Lake. |
| Form 990 Part VI Line 7a | MARSHFIELD CLINIC HEALTH SYSTEM, INC. (as the sole member) HAS THE AUTHORITY TO APPOINT MAJORITY OF THE CORPORATE BOARD MEMBERS AND APPROVE THE PUBLIC DIRECTORS of Lakeview Medical Center Inc. of Rice Lake. |
| Form 990 Part VI Line 7b | Marshfield Clinic Health System, Inc. (the sole member) has the right to approve any changes to the articles of incorporation and bylaws of Lakeview Medical Center Inc. of Rice Lake. Marshfield Clinic Health System, Inc. (the sole member) also has the right to initiate and approve any of the following actions: merger, consolidation, affiliation or joint venture with any other entity or entities; liquidation, reorganization or dissolution of the organization; filing of a voluntary petition in bankruptcy; any change in control of the organization. |
| Form 990 Part VI Line 11b | Marshfield Clinic Health System, Inc. engages a public accounting firm to prepare and review the Form 990 in addition to review by the System CFO, VP of Finance and Controller. Prior to filing the form with the IRS, the CFO and his/her designee will provide to each member of the System's Audit and Compliance Committee (a subcommittee of the Board of Directors) a copy in electronic or paper form of the completed Form 990 (and all required schedules) for review and approval. |
| Form 990 Part VI Line 12c | ALL OFFICERS, BOARD DIRECTORS, AND KEY EMPLOYEES OF EVERY MARSHFIELD CLINIC HEALTH SYSTEM (MCHS) ENTITY, AS WELL AS ANY OTHER PERSON DESIGNATED BY THE AUDIT AND COMPLIANCE COMMITTEE (ACC) TO BE A REQUIRED REPORTER BY VIRTUE OF HIS OR HER POSITION AT A SYSTEM ENTITY, SHALL ANNUALLY COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. SUCH FORMS SHALL BE DISTRIBUTED AND RECORDED BY THE SYSTEM'S DESIGNATED COMPLIANCE OFFICER. ALL FINANCIAL INTERESTS DISCLOSED AS PART OF THE ANNUAL DISCLOSURE PROCESS SHALL BE REVIEWED BY THE ACC. THE ACC SHALL INFORM THE BOARD OF DISCLOSED FINANCIAL INTERESTS WHICH MAY BEAR UPON OR RELATE TO A TRANSACTION UPON WHICH THE BOARD OR ANOTHER BOARD, COMMITTEE OR OTHER BODY OF A SYSTEM ENTITY, MAY DELIBERATE OR ACT. IN ADDITION TO THE ANNUAL DISCLOSURES, IF AT ANY TIME BETWEEN ANNUAL DISCLOSURES, A REQUIRED REPORTER BECOMES AWARE THAT THE BOARD, OR A BOARD, COMMITTEE OR OTHER BODY, OF ANY SYSTEM ENTITY MAY DELIBERATE OR ACT UPON ANY TRANSACTION THAT MAY HAVE ANY BEARING OF ANY KIND UPON, OR MAY RELATE IN ANY MANNER TO, AN EXISTING, INTENDED OR EXPECTED FINANCIAL INTEREST OF THE REQUIRED REPORTER, HE OR SHE SHALL DISCLOSE THE FINANCIAL INTEREST TO THE RELEVANT SYSTEM ENTITY BOARD, COMMITTEE OR BODY CHAIR, AS WELL AS TO THE SYSTEM'S COMPLIANCE OFFICER, IN ADVANCE OF ANY DELIBERATIONS OR ACTION, WRITTEN DISCLOSURE OF THE EXISTENCE, NATURE AND EXTENT OF HIS OR HER FINANCIAL INTEREST. ALL WRITTEN OR ORAL DISCLOSURES OF FINANCIAL INTERESTS SHALL BE RECORDED IN THE MINUTES OF THE BOARD AND BY THE OFFICE OF THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER SHALL DISCLOSE THE COMPLETED FORMS AS NECESSARY TO THOSE MCHS EMPLOYEES RESPONSIBLE FOR COMPLETION OF THE IRS FORM 990. |
| Form 990 Part VI Line 15a | The System's independent compensation committee (compensation committee) shall have final authority for approving compensation and benefits of all "disqualified persons" (as that term is defined in 4958 of the Internal Revenue Code (the "code")) employed by the corporation, including but not limited to the corporation's CEO. The term "disqualified persons" includes (but is not limited to) any person (or the person's family member) who was, at any time during the 5-year period ending on the date of the transaction, in a position to exercise substantial influence over the affairs of the organization. It shall be the responsibility of the compensation committee to insure that the system does not pay an amount that exceeds reasonable compensation for any disqualified person. The compensation committee and its operating procedures shall be designed to establish the rebuttable presumption of reasonableness of compensation outlined in Treasury Reg. Sec. 53.4958-6 with respect to each disqualified person. In determining reasonableness of compensation, the compensation committee shall evaluate appropriate information as to the comparability of compensation, including but not limited to: compensation levels paid by similarly situated organizations for comparable positions; the availability of similar services in the system's geographic area; current compensation surveys compiled by independent firms; and actual written job offers from similar institutions. The ICC shall have independent authority to obtain outside expert opinions on the reasonableness and fair market value of compensation and gather other information the committee considers necessary or appropriate to make its decisions on compensation. The compensation committee shall timely document its determination of reasonableness of compensation. |
| Form 990 Part VI Line 19 | Lakeview Medical Center Inc. of Rice Lake does not make its current governing documents, conflict of interest policy or financial statements available to the public unless included as part of a form that is required to be publicly available. |
| Form 990 Part XI Line 9 | Lakeview Medical Center provided cash distributions and other transfers to Marshfield Clinic of $25,486,642 and received a transfer from Marshfield Clinic Health System, Inc. of $37,153. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| MARSHFIELD CLINIC Inc | ||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 390452970 | MEDICAL CARE | WI | 501(C)(3) | 3 | MCHS | false |
| VOLUNTEER PARTNERS OF LAKEVIEW MEDICAL | ||||||||||
| 1700 W STOUT STREET | RICE LAKE | WI | 54868 | 391329084 | SUPPORT ORG | WI | 501(C)(3) | 12-TYPE III | NA | false |
| SECURITY HEALTH PLAN OF WISCONSIN INC | ||||||||||
| 1515 N ST JOSEPHS AVE | MARSHFIELD | WI | 54449 | 391572880 | HMO | WI | 501(C)(4) | N/A | MCHS | false |
| MARSHFIELD CLINIC HERITAGE FNDTN INC | ||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 391865942 | HONOR INDVDLS | WI | 501(C)(3) | 12-TYPE I | NA | false |
| FLAMBEAU HOSPITAL INC | ||||||||||
| 98 SHERRY AVE | PARK FALLS | WI | 54552 | 390973724 | HOSPITAL | WI | 501(C)(3) | 3 | NA | false |
| MARSHFIELD CLINIC HEALTH SYSTEM INC | ||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 461495343 | HOSPITAL | WI | 501(C)(3) | 12 TYPE III | NA | false |
| FAMILY HEALTH CENTER OF MARSHFIELD INC | ||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 391681547 | COM HLTH CTR | WI | 501(C)(3) | 7 | NA | false |
| MCHS HOSPITALS INC | ||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 810977948 | HOSPITAL | WI | 501(C)(3) | 3 | MCHS | false |
| MCHS FOUNDATION INC | ||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 812822823 | PHILANTHROPY | WI | 501(C)(3) | 7 | MCHS | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE DIAGNOSTIC & TREATMENT center LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3401 CRANBERRY BLVD | AddressLine1Txt |
| City | WESTON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54476 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200691634 | EIN |
| Primary Activities | MEDICAL SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $0 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $0 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCIS INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1701 N FIG AVE | AddressLine1Txt |
| City | MARSHFIELD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54449 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 472138889 | EIN |
| Primary Activities | IT SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C Corp | EntityTypeTxt |
| Share Of Total Income | $0 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $0 | ShareOfEOYAssetsAmt |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Form Sch R | FormAndLineReferenceDesc |
| Explanation | Marshfield Clinic Health System, Inc. (a 501(c)(3) organization), is the parent organization of Lakeview Medical Center Inc. of Rice Lake. The following companies are related to Lakeview Medical Center Inc. of Rice Lake through brother/sister relationships due to a common parent organization: Marshfield Clinic, Inc. Security Health Plan of Wisconsin, Inc. Flambeau Hospital, Inc. MCIS, Inc. Marshfield Clinic Health System Foundation, Inc. MCHS Hospitals, Inc. | ExplanationTxt |