SPOONER HEALTH SYSTEM INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- SPOONER HEALTH SYSTEM INC (EIN 39-0892183)
- Tax period
- 2014-04-01 to 2015-03-31
- Filed
- 2016-01-11
- IRS object ID
- 201620119349300832
- Schema version
- 2014v6.0
- 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 G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-01-11T09:56:19-06:00 | ReturnTs |
| Tax Period End | 2015-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 SOUTH SIXTH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390892183 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPOONER HEALTH SYSTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SPOO | BusinessNameControlTxt |
| Phone | 7156351225 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 819 ASH STREET | AddressLine1Txt |
| City | SPOONER | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54801 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL D SCHAFER | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 7156351225 | PhoneNum |
| Signature | 2016-01-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KOREY BOELTER | PreparerPersonNm |
| PTIN | P00775161 | PTIN |
| Phone | 6123764500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-04-25 22:37:26Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL D SCHAFER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 819 ASH STREET | AddressLine1Txt |
| City | SPOONER | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $25,362,397 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SPOONERHEALTHSYSTEM.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1955 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY HEALTHCARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 163 | TotalEmployeeCnt |
| Total Volunteers | 54 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $42,303 | PYContributionsGrantsAmt |
| CY Contributions Grants | $30,221 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,125,601 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $19,576,856 | CYProgramServiceRevenueAmt |
| PY Investment Income | $452,054 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,610,862 | CYInvestmentIncomeAmt |
| PY Other Revenue | $222,400 | PYOtherRevenueAmt |
| CY Other Revenue | $66,030 | CYOtherRevenueAmt |
| PY Total Revenue | $19,842,358 | PYTotalRevenueAmt |
| CY Total Revenue | $21,283,969 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $101,026 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $5,796 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,661,749 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,099,524 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,057,604 | PYOtherExpensesAmt |
| CY Other Expenses | $9,068,489 | CYOtherExpensesAmt |
| PY Total Expenses | $17,820,379 | PYTotalExpensesAmt |
| CY Total Expenses | $18,173,809 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,021,979 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,110,160 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $25,843,763 | TotalAssetsBOYAmt |
| Total Assets EOY | $47,691,063 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,548,741 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $23,913,106 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $22,295,022 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,777,957 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE HIGH QUALITY HEALTHCARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $12,401,626 | ExpenseAmt |
| Grant | $5,796 | GrantAmt |
| Revenue | $19,251,954 | RevenueAmt |
| Desc | SPOONER HEALTH SYSTEM PLAYS A VITAL ROLE IN THE HEALTH AND WELL-BEING OF THE COMMUNITY BY OFFERING SERVICES TO PATIENTS SUCH AS 24-HOUR EMERGENCY CARE, ACUTE CARE, SURGICAL, OBSTETRICS, REHABILITATION, DIAGNOSTIC, AND HOSPICE CARE. FOR THE FISCAL YEAR ENDING 3/31/15, THERE WERE 1,965 INPATIENT DAYS, 438 INPATIENT DISCHARGES, 76 NEWBORN DAYS, 14,708 OUTPATIENT VISITS, 6,542 EMERGENCY ROOM VISITS, AND 408 SURGERIES. SPOONER HEALTH SYSTEM PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS/RESIDENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. A FINANCIAL ASSISTANCE PROGRAM IS ALSO AVAILABLE FOR PATIENTS FINANCIALLY UNABLE TO PAY FOR SERVICES PROVIDED. THIS PROGRAM INCLUDES FEE DISCOUNTS, AS WELL AS 100% FREE CARE. SPOONER HEALTH SYSTEM ALSO PROVIDES NUMEROUS HEALTHCARE AND WELLNESS CLASSES, SUPPORT GROUPS, AND VARIOUS EDUCATIONAL/HEALTH SCREENING OPPORTUNITIES AS A COMMUNITY BENEFIT. THESE PROGRAMS ARE OFFERED TO ITS PATIENTS, THEIR FAMILIES, EMPLOYEES, COMMUNITY MEMBERS AND THE GENERAL PUBLIC. SPOONER HEALTH SYSTEM ALSO RECEIVES DONATED SERVICES FROM COMMUNITY VOLUNTEERS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $865,604 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $324,902 | RevenueAmt |
| Desc | THE HOME HEALTH AGENCY PROVIDES NURSING AND REHABILITATION SERVICES TO PATIENTS IN THEIR HOME. FOR THE FISCAL YEAR ENDING 3/31/15, THERE WERE 2,411 HOME HEALTH VISITS, 113 ADMITTED CASES, AND 127 DISCHARGED CASES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $13,267,230 | 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | 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 | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 26 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 163 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REBECCA BUSCH CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7156351225 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 819 ASH STREET | AddressLine1Txt |
| City | SPOONER | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54801 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| JAMIE MORALES | |||||||
| BOARD PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MICHAEL KNOEPKE | |||||||
| BOARD VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ADAM LIEGL | |||||||
| BOARD TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DON HAACK | |||||||
| FORMER BOARD TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARK VAN ETTEN MD | |||||||
| BOARD SECRETARY/MEDICAL DIRECTOR | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SHELDON JOHNSON | |||||||
| BOARD MEMBER/FORMER PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| NANCY MARKGREN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MAUREEN REVAK | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL SCHAFER | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| REBECCA BUSCH | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $116,651 | $0 | $16,765 | ||
| TIMOTHY BASSETT | |||||||
| PHARMACY DIRECTOR | 40.00 | $131,507 | $0 | $12,325 | Yes (X) | ||
| KEN ENGEL | |||||||
| PHARMACIST | 40.00 | $130,239 | $0 | $15,162 | Yes (X) | ||
| PATRICK MCCANN MD | |||||||
| ER MEDICAL DIRECTOR | 40.00 | $237,536 | $0 | $35,049 | Yes (X) | ||
| ANNE MENTELE CRNA | |||||||
| CERT. NURSE ANESTHETIST | 40.00 | $162,982 | $0 | $32,421 | Yes (X) | ||
| TIMOTHY SCHMIDT CRNA | |||||||
| CERT. NURSE ANESTHETIST | 40.00 | $159,718 | $0 | $32,714 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $938,633 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $144,436 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | 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 |
|---|---|---|---|---|---|
| BWBR ARCHITECTS | |||||
| 380 ST PETER STREET SUITE 600 | SAINT PAUL | MN | 55102 | ARCHITECT FEES | $1,095,831 |
| WAPITI MEDICAL GROUP-WOOD RIVER LLC | |||||
| 107 FLYNN DRIVE STE 600 | MILBANK | SD | 57252 | ER PHYSICIAN COVERAGE | $908,249 |
| HEALTHTECH MANAGEMENT SERVICES | |||||
| 5110 MARYLAND WAY STE 200 | BRENTWOOD | TN | 37027 | MANAGEMENT FEES | $535,018 |
| SHARED MEDICAL TECHNOLOGY INC | |||||
| 202 W NEWTON ST | RICE LAKE | WI | 54868 | DIAGNOSTIC RADIOLOGY | $519,283 |
| CPSI | |||||
| PO BOX 850309 | MOBILE | AL | 36685 | COMPUTER SUPPORT | $243,854 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $7,814 | FundraisingAmt |
| Government Grants | $21,903 | GovernmentGrantsAmt |
| All Other Contributions | $504 | AllOtherContributionsAmt |
| Total Contributions | $30,221 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REV. | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $19,576,856 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,576,856 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $19,576,856 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $253,999 | TotalRevenueColumnAmt |
| Exclusion | $253,999 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $70,565 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $25,762 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $44,803 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,803 | TotalRevenueColumnAmt |
| Exclusion | $44,803 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,400,000 | SecuritiesAmt |
| Other | $500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,043,637 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,356,363 | SecuritiesAmt |
| Other | $500 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,356,863 | TotalRevenueColumnAmt |
| Exclusion | $1,356,863 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $7,315 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $7,814 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $9,029 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,714 | TotalRevenueColumnAmt |
| Exclusion | -$1,714 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $22,941 | TotalRevenueColumnAmt |
| Exclusion | $22,941 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $22,941 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,283,969 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,576,856 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,676,892 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,796 | TotalAmt |
| Program Services | $5,796 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,418 | TotalAmt |
| Management And General | $135,418 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,988,766 | TotalAmt |
| Program Services | $6,088,542 | ProgramServicesAmt |
| Management And General | $900,224 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,856 | TotalAmt |
| Program Services | $147,977 | ProgramServicesAmt |
| Management And General | $21,879 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,305,268 | TotalAmt |
| Program Services | $1,137,136 | ProgramServicesAmt |
| Management And General | $168,132 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $500,216 | TotalAmt |
| Program Services | $435,783 | ProgramServicesAmt |
| Management And General | $64,433 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $601,307 | TotalAmt |
| Management And General | $601,307 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $132,796 | TotalAmt |
| Management And General | $132,796 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,714 | TotalAmt |
| Management And General | $50,714 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,368,752 | TotalAmt |
| Program Services | $2,323,364 | ProgramServicesAmt |
| Management And General | $45,388 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $209,812 | TotalAmt |
| Management And General | $209,812 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $213,854 | TotalAmt |
| Program Services | $110,639 | ProgramServicesAmt |
| Management And General | $103,215 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,009 | TotalAmt |
| Program Services | $81,542 | ProgramServicesAmt |
| Management And General | $189,467 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $643,641 | TotalAmt |
| Program Services | $624,145 | ProgramServicesAmt |
| Management And General | $19,496 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,892 | TotalAmt |
| Program Services | $87,415 | ProgramServicesAmt |
| Management And General | $25,477 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,697 | TotalAmt |
| Program Services | $44,618 | ProgramServicesAmt |
| Management And General | $8,079 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,363 | TotalAmt |
| Program Services | $11,363 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,774,409 | TotalAmt |
| Management And General | $1,774,409 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,903 | TotalAmt |
| Management And General | $89,903 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DRUGS | $1,052,781 | $1,052,781 | |
| MEDICAL SUPPLIES | $804,362 | $754,937 | $49,425 |
| BAD DEBT EXPENSE | $545,588 | $331,648 | $213,940 |
| DUES/SUBSCRIPTIONS | $81,339 | $29,544 | $51,795 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,270 | TotalAmt |
| Management And General | $51,270 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,173,809 | TotalAmt |
| Program Services | $13,267,230 | ProgramServicesAmt |
| Management And General | $4,906,579 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $630 | BOYAmt |
| EOY | $700 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,877,378 | BOYAmt |
| EOY | $26,802,135 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,830,773 | BOYAmt |
| EOY | $2,562,238 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,923 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $181,832 | BOYAmt |
| EOY | $219,312 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $228,212 | BOYAmt |
| EOY | $147,267 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $22,475,594 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $14,627,111 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,274,153 | BOYAmt |
| EOY | $7,848,483 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,436,427 | BOYAmt |
| EOY | $9,550,217 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $435 | BOYAmt |
| EOY | $560,711 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,843,763 | BOYAmt |
| EOY | $47,691,063 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,574,210 | BOYAmt |
| EOY | $2,621,106 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,753 | BOYAmt |
| EOY | $21,200,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $847,778 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,000 | BOYAmt |
| EOY | $92,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,548,741 | BOYAmt |
| EOY | $23,913,106 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,643,897 | BOYAmt |
| EOY | $23,764,332 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $651,125 | BOYAmt |
| EOY | $13,625 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,295,022 | BOYAmt |
| EOY | $23,777,957 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,843,763 | BOYAmt |
| EOY | $47,691,063 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,110,160 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,049,725 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$577,500 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $984,772 | OtherCostOrOtherBasisAmt |
| Book Value | $984,772 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,486,236 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,958,628 | DepreciationAmt |
| Book Value | $1,527,608 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,739,664 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,668,483 | DepreciationAmt |
| Book Value | $1,071,181 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,264,922 | OtherCostOrOtherBasisAmt |
| Book Value | $4,264,922 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,848,483 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ASSET RETIREMENT OBLIGATION | Desc |
| Amt | $92,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $92,000 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $20,523,455 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$760,514 | OtherRevenueAmt |
| Revenue Not Reported | -$760,514 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,283,969 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $21,283,969 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $17,353,295 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$60,000 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$60,000 | ExpensesNotReportedAmt |
| Expenses Subtotal | $17,413,295 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $760,514 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $760,514 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $18,173,809 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE ORGANIZATION IS CLASSIFIED BY THE INTERNAL REVENUE SERVICE AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS SUBJECTED TO FEDERAL INCOME TAX ONLY ON NET UNRELATED BUSINESS INCOME. THE ORGANIZATION HAS ELECTED TO ADOPT GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES FOR EVALUATING UNCERTAIN TAX POSITIONS. THE ADOPTION OF THIS STANDARD HAS NO EFFECT ON THE FINANCIAL STATEMENTS. THE ORGANIZATION'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. THE TAX RETURNS FOR THE YEARS 2012 TO 2014 ARE OPEN TO EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS -760,514. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | REVERSAL OF PRIOR YEAR GRANT TO BLCS THAT DID NOT GET PAID -60,000. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBT 760,514. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | SHS GOLF OUTING | Event1Nm |
| Gross Receipts Event1 | $15,129 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $7,814 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $7,315 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $2,651 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $3,207 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $1,457 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $1,714 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $15,129 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $7,814 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $7,315 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $2,651 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $3,207 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $1,457 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,714 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $9,029 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$1,714 | NetIncomeSummaryAmt |
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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| 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 | $238,265 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $238,265 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01370 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,363,593 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,707,414 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,656,179 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09510 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,601,858 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,707,414 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,894,444 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10880 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 15166 | PersonsServedCnt |
| Total Community Benefit Expns | $47,680 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,314 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $37,366 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 57 | PersonsServedCnt |
| Total Community Benefit Expns | $19,591 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $19,591 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 297 | PersonsServedCnt |
| Total Community Benefit Expns | $599,219 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $341,455 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $257,764 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01480 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $50,311 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $50,311 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00290 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 15520 | PersonsServedCnt |
| Total Community Benefit Expns | $716,801 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $351,769 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $365,032 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02090 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 15520 | PersonsServedCnt |
| Total Community Benefit Expns | $4,318,659 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,059,183 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,259,476 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12970 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $723 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $723 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 8 | PersonsServedCnt |
| Total Community Benefit Expns | $11,621 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,621 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $513 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $513 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 128 | PersonsServedCnt |
| Total Community Benefit Expns | $669 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $669 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $1,499 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,499 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 186 | PersonsServedCnt |
| Total Community Benefit Expns | $14,838 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,838 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 322 | PersonsServedCnt |
| Total Community Benefit Expns | $29,863 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $29,863 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $760,514 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,336,930 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,716,150 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$379,220 | 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 |
| 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 | SPOONER HEALTH SYSTEM INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 819 ASH STREET | AddressLine1Txt |
| City | SPOONER | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SPOONERHEALTHSYSTEM.COM | WebsiteAddressTxt |
| State License | 1024 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | HOME HEALTH AGENCY | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPOONER HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.SPOONERHEALTHSYSTEM.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.SPOONERHEALTHSYSTEM.COM/BILLINGINSURANCEPOLICY/TABID/130/DEFAULT.ASPX | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SPOONER HEALTH SYSTEM | PART V, SECTION B, LINE 5: A SURVEY INSTRUMENT WAS DEVELOPED IN COOPERATION WITH THE NATIONAL RURAL HEALTH RESOURCE CENTER (THE CENTER) AND SPOONER HEALTH SYSTEM (SHS) TO ASSESS THE HEALTH CARE NEEDS AND PREFERENCES IN THE SERVICE AREA. THE SURVEY INSTRUMENT WAS DESIGNED TO BE EASILY COMPLETED BY RESPONDENTS. THE SURVEY WAS DESIGNED TO ASSEMBLE INFORMATION FROM LOCAL RESIDENTS REGARDING: DEMOGRAPHICS OF RESPONDENTS, UTILIZATION AND PERCEPTION OF LOCAL HEALTH SERVICES, AND PERCEPTION OF COMMUNITY HEALTH. ZIP CODES WITH THE GREATEST NUMBER OF ADMISSIONS WERE STRATIFIED IN THE INITIAL SAMPLE SELECTION. EACH AREA WOULD BE REPRESENTED IN THE SAMPLING PROPORTIONATELY TO BOTH THE OVERALL SERVED POPULATION AND THE NUMBER OF PAST ADMISSIONS. EIGHT HUNDRED RESIDENTS WERE SELECTED RANDOMLY FROM PRIME NET DATA SOURCE, A MARKETING ORGANIZATION. THE COMMUNITY HEALTH NEEDS ASSESSMENT, A COVER LETTER ON SPOONER HEALTH SYSTEM'S LETTERHEAD, AND A POSTAGE PAID REPLY ENVELOPE WERE MAILED FIRST CLASS TO 800 RANDOMLY SELECTED RESIDENTS IN THE TARGETED REGION. A PRESS RELEASE WAS SENT TO LOCAL NEWSPAPERS PRIOR TO THE SURVEY DISTRIBUTION ANNOUNCING THAT SPOONER WOULD CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT THROUGHOUT THE REGION IN COOPERATION WITH THE CENTER. ONE HUNDRED THIRTY-NINE OF THE MAILED SURVEYS WERE RETURNED PROVIDING A 19% RESPONSE RATE. IN ADDITION, SHS HAD THE CENTER CONDUCT FOCUS GROUPS TO PROVIDE QUALITATIVE DATA AS A SUPPLEMENT TO THE COMMUNITY SURVEY. THE PURPOSE OF THE FOCUS GROUPS WAS TO HEAR DIRECTLY FROM LOCAL RESIDENTS ON THE STRENGTHS AND NEEDS OF HEALTH SERVICES IN THE SPOONER AREA. FOCUS GROUP PARTICIPANTS WERE IDENTIFIED AS PEOPLE LIVING IN SPOONER AND THE SURROUNDING AREA. INVITATIONS WERE MAILED WITH THE FOCUS GROUP QUESTIONS ATTACHED. THIRTY PEOPLE PARTICIPATED IN TOTAL. THE FOCUS GROUPS WERE DESIGNED TO REPRESENT VARIOUS CONSUMER GROUPS OF LOCAL HEALTH SERVICES INCLUDING SENIOR CITIZENS, CAREGIVERS, BUSINESS OWNERS AND HEALTH CARE PROVIDERS. |
| SPOONER HEALTH SYSTEM | PART V, SECTION B, LINE 11: 1) LACK OF ACCESS TO DENTAL CARE - SPOONER HEALTH SYSTEM IS NOT ADDRESSING THIS IDENTIFIED NEED BECAUSE WE DO NOT HAVE EXPERTISE IN THE DENTISTRY AREA. IT'S SIMPLY OUT OF OUR SCOPE OF PRACTICE. DUE TO OTHER HEALTH PRIORITIES, WE DO NOT HAVE THE FINANCES TO SUPPORT DENTAL CARE AS WELL. 2) NO 24-HOUR PHARMACY - SPOONER HEALTH SYSTEM IS NOT ADDRESSING THIS IDENTIFIED NEED FOR THE FOLLOWING REASONS:- WE DO NOT CURRENTLY DO RETAIL PHARMACY AND DON'T WANT TO BEGIN COMPETING WITH OTHERS IN THE COMMUNITY WHO DO.-WE'VE LOOKED AT MEDICINE VENDING OPTIONS. HOWEVER, IT IS NOT FEASIBLE DUE TO LOW VOLUMES AND MINIMUM REQUIREMENTS.- WE DO NOT THINK IT IS IN THE BEST INTEREST OF OUR COMMUNITY TO PULL RESOURCES FROM OTHER IDENTIFIED NEEDS AND PRIORITIES TO PROVIDE THIS SERVICE.3) NO MINUTE CLINIC - SPOONER HEALTH SYSTEM IS NOT ADDRESSING THIS IDENTIFIED NEED FOR THE FOLLOWING REASONS:- WE DO NOT EMPLOY THE PHYSICIANS.- SPACE CONSTRAINTS.NOTE THAT WE ARE CONSIDERING URGENT CARE WITH POSSIBLE FUTURE BUILDING PROJECT. |
| SPOONER HEALTH SYSTEM | PART V, SECTION B, LINE 16I: ALTHOUGH THE ACTUAL POLICY AND PROCEDURE IS NOT ON THE WEBSITE, BASIC INFORMATION IS POSTED REGARDING THE FACT THAT FINANCIAL ASSISTANCE IS AVAILABLE. THE INFORMATION ON THE WEBSITE EXPLAINS EXACTLY WHAT TO DO IN ORDER TO APPLY FOR FINANCIAL ASSISTANCE. THE APPLICATION FORM IS ALSO AVAILABLE ON THE WEBSITE AND AT REGISTRATION. FINANCIAL ASSISTANCE APPLICATION AND LETTER IS SENT OUT TO PATIENTS WHO ARE NOT ABLE TO PAY THEIR BALANCES DUE. |
| PART V, SECTION B, LINE 16 | FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY |
| SPOONER HEALTH SYSTEM PART V, SECTION B, LINE 16B WEBSITE: | WWW.SPOONERHEALTHSYSTEM.COM/BILLINGINSURANCEPOLICY/TABID/130/DEFAULT.ASPX |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE AMOUNTS REPORTED IN PART I, LINE 7A-C WERE COMPUTED USING THE COST TO CHARGE RATIO FROM WORKSHEET 2 OF THE SCHEDULE H, IRS INSTRUCTIONS. THE AMOUNTS REPORTED IN LINES 7E-I WERE REPORTED BASED ON DIRECT COSTS INCURRED BY SHS. |
| PART I, LINE 7G: | INCLUDED IN PART I, LINE 7G IS THE MEMORY CLINIC, WHICH IS A PHYSICIAN CLINIC. IT IS LISTED AS A SUBSIDIZED HEALTH SERVICE BECAUSE IT IS OPERATED BY SHS IN ORDER TO PROVIDE A SERVICE THAT IS NEEDED IN THE COMMUNITY, BUT CANNOT BE SUSTAINED ON ITS OWN. THE TOTAL COMMUNITY BENEFIT EXPENSE FOR THE MEMORY CLINIC WAS $17,096 WITH DIRECT OFFSETTING REVENUE OF $14,398 RESULTING IN NET COMMUNITY BENEFIT EXPENSE OF $2,698. |
| PART I, LN 7 COL(F): | THE HOSPITAL IS REPORTING $760,514 OF BAD DEBT EXPENSE IN FORM 990, PART IX, LINE 24B. TOTAL EXPENSE, LESS THIS AMOUNT, ARE $17,418,872. THIS AMOUNT IS USED TO CALCULATE THE PERCENTAGE OF TOTAL EXPENSE IN SCHEDULE H, PART I, LINE 7, COLUMN F. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | SPOONER HEALTH SYSTEM (SHS) IS PARTNERED WITH WASHBURN COUNTY AND THE STATE OF WISCONSIN IN THEIR EMERGENCY PREPAREDNESS EFFORTS THROUGH INVOLVEMENT WITH THE NORTHWEST WISCONSIN HEALTH CARE COALITION AND REGIONAL TRAUMA ADVISORY COUNCIL. SHS IS ALSO PARTNERED WITH THE FOLLOWING ORGANIZATIONS THAT DIRECTLY PROMOTE HEALTH OF PERSONS LIVING IN WASHBURN AND BURNETT COUNTIES: DRUG ENDANGERED CHILDREN M TEAM, WASHBURN COUNTY SAFETY COALITION, ELDER ABUSE INTERDISCIPLINARY TEAM, WASHBURN COUNTY AND POLK BURNETT COUNTY CARE TRANSITION COALITION, FAITH IN ACTION, TIME OUT SHELTER, AND BURNETT CRISIS OVERSIGHT COMMITTEE. |
| PART III, LINE 4: | THE FOLLOWING IS FROM THE "PATIENT AND RESIDENT RECEIVABLES, NET" PARAGRAPH IN NOTE 1 TO THE HOSPITAL'S FINANCIAL STATEMENTS:"PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT 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 DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL 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 DOUBTFUL ACCOUNTS."THE AMOUNT OF BAD DEBT EXPENSE REPORTED IN PART III, LINE 2 IS CALCULATED AS FOLLOWS: PAYMENT ARRANGEMENT INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS.A PORTION OF THE BAD DEBT EXPENSE REPORTED IN LINE 2 WOULD BE CONSIDERED CHARITY CARE IF THE PROPER PAPERWORK WAS COMPLETED, HOWEVER THIS AMOUNT CANNOT BE QUANTIFIED. |
| PART III, LINE 8: | FROM PART III, LINE 6, THE TOTAL ALLOWABLE COST REPORTED TO MEDICARE WAS BASED ON THE 2015 FILED MEDICARE COST REPORT.FROM PART III, LINE 7, SPOONER HEALTH SYSTEM BELIEVES THAT THE SHORTFALL OF $379,220 SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE THESE ARE THE COSTS OF PROVIDING MEDICALLY NECESSARY SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IF THE HOSPITAL DIDN'T PROVIDE THESE SERVICES, NO OTHER ORGANIZATION IN THE COMMUNITY WOULD. |
| PART III, LINE 9B: | AFTER FINANCIAL ASSISTANCE IS PROVIDED, SPOONER HEALTH SYSTEM WILL CONTINUE TO WORK WITH PATIENTS TO RESOLVE THE REMAINDER OF THEIR BALANCE AFTER FINANCIAL ASSISTANCE. SPOONER HEALTH SYSTEM MAKES ALL REASONABLE ATTEMPTS TO CONFIRM THAT PATIENTS ARE NOT ELIGIBLE FOR OTHER ASSISTANCE PROGRAMS PRIOR TO COLLECTION AGENCY ASSIGNMENT. PRIOR TO TRANSFER TO A COLLECTION AGENCY, SPOONER HEALTH SYSTEM WILL SEND STATEMENTS AND COLLECTION LETTERS TO THE PATIENT AT THE ADDRESS PROVIDED BY THE PATIENT. STATEMENTS AND COMMUNICATIONS WILL INFORM THE PATIENT OF THEIR FINANCIAL RESPONSIBILITY AFTER FINANCIAL ASSISTANCE. AFTER PAYMENT PLAN ARRANGEMENTS HAVE BEEN MADE AND BEFORE TRANSFER TO A COLLECTION AGENCY, SPOONER HEALTH SYSTEM WILL SEND A NOTICE TO PATIENTS WHO HAVE FAILED TO MAKE PAYMENT ARRANGEMENTS OR WHO DO NOT COMPLY WITH MUTUALLY AGREED UPON PAYMENT PLANS. THE NOTICE WILL ALERT THE PATIENT OF THEIR BALANCE AND THAT IF THEIR FINANCIAL SITUATION HAS CHANGED, THEY MAY HAVE THE OPPORTUNITY FOR A NEW PAYMENT PLAN. |
| PART VI, LINE 2: | SPOONER HEALTH SYSTEM (SHS) PARTICIPATED IN A COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS ADMINISTRATED BY THE NATIONAL RURAL HEALTH RESOURCE CENTER (THE CENTER) IN DULUTH, MINNESOTA. THIS PROCESS INCLUDED THE DEVELOPMENT AND DISTRIBUTION OF A STRATIFIED, RANDOM SAMPLE MAILED COMMUNITY HEALTH NEEDS SURVEY, FACILITATION OF FOCUS GROUPS AND ANALYSIS OF SECONDARY DATA. THESE METHODS ENABLED SHS THE OPPORTUNITY TO LISTEN AND RESPOND TO THE HEALTH NEEDS OF THE COMMUNITY. RESULTS OF THE ASSESSMENT FINDINGS WERE USED TO IDENTIFY LOCAL HEALTH PRIORITIES AND ESTABLISH HEALTH GOALS AND AN ACTION PLAN FOR THE PURPOSES OF:- IMPROVING OVERALL COMMUNITY HEALTH- PROMOTING COLLABORATION AND PARTNERSHIPS WITHIN SPOONER AND THE SURROUNDING AREA TO ADDRESS TOP COMMUNITY HEALTH NEEDS- IMPROVING COMMUNICATION ACROSS HEALTH SECTORS- CREATING AWARENESS OF THE COMPREHENSIVE, HIGH QUALITY HEALTH CARE SERVICES AVAILABLE LOCALLY- REINFORCING A COMMITMENT TO THE PEOPLE OF SPOONER AND THE SURROUNDING AREA THAT THEIR HEALTH IS THE HOSPITAL'S TOP PRIORITY |
| PART VI, LINE 3: | PATIENTS WITHOUT INSURANCE ARE GIVEN THE FINANCIAL ASSISTANCE (FA) APPLICATION. OUR FINANCIAL COUNSELOR CALLS THEM AFTER DISCHARGE AND EXPLAINS WHAT ASSISTANCE (FROM THE GOVERNMENT OR SHS) MAY BE AVAILABLE TO THEM. SHE ASKS THEM TO FILL IT OUT AND MAKES AN APPOINTMENT WITH THEM IN THE OFFICE IF THEY NEED ASSISTANCE WITH THE FA APPLICATION OR GOING TO WWW.ACCESS.GOV TO APPLY FOR GOVERNMENTAL ASSISTANCE. WHEN THEY COME IN, SHE WILL ASSIST THEM WITH THE APPLICATION PROCESS AS MUCH AS SHE CAN. IF THEY NEED FURTHER ASSISTANCE, ARE OF RETIREMENT AGE, OR IF THERE IS A DISABILITY INVOLVED, SHE REFERS THEM TO THE WASHBURN COUNTY AGING AND DISABILITY RESOURCE CENTER WHERE THEY WILL HELP THE PATIENTS IN GETTING ADDITIONAL ASSISTANCE. OUR FINANCIAL COUNSELOR ALSO REFERS PATIENTS TO THE COUNTY'S PUBLIC HEALTH DEPARTMENT IF THEY NEED FAMILY OR WOMEN'S HEALTH ASSISTANCE. |
| PART VI, LINE 4: | SPOONER HEALTH SYSTEM PRIMARILY SERVES THE COMMUNITIES WITHIN WASHBURN COUNTY IN NORTHWESTERN WISCONSIN. WASHBURN COUNTY IS THE 30TH LARGEST COUNTY BY LAND AREA IN WISCONSIN WITH AN ESTIMATED POPULATION OF 15,686 (PER 2013 US CENSUS BUREAU). THE MEDIAN HOUSEHOLD INCOME IS $41,924 WITH 13.8% OF PERSONS BELOW POVERTY LEVEL (PER 2009-2013 DATA). WASHBURN COUNTY HAD A 5.3% UNEMPLOYMENT RATE IN APRIL 2015 PER DWD, BUREAU OF WORKFORCE TRAINING. |
| PART VI, LINE 6: | SPOONER HEALTH SYSTEM IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | TUITION REIMBURSEMENT | GrantTypeTxt |
| Recipient | 1 | RecipientCnt |
| Cash Grant | $5,796 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | SPOONER HEALTH SYSTEM ALSO OFFERS TUITION ASSISTANCE FOR EMPLOYEES THAT ARE FURTHERING THEIR EDUCATION TO ENHANCE THEIR JOB RELATED SKILLS, KNOWLEDGE AND IMPROVE THEIR POTENTIAL FOR PROMOTION OR CAREER DEVELOPMENT OPPORTUNITIES. TO RECEIVE TUITION REIMBURSEMENT FROM THE HOSPITAL, AN EMPLOYEE MUST SUBMIT A TUITION ASSISTANCE IN EXCHANGE FOR SERVICE FROM THE HUMAN RESOURCES DEPARTMENT ALONG WITH THE APPROPRIATE DOCUMENTATION. THIS INCLUDES WRITTEN PROOF OF SUCCESSFUL COMPLETION OF THE COURSE PER THE COURSE REQUIREMENTS AND ITEMIZED BILLS, RECEIPTS OR STATEMENTS WITH PROOF OF PAYMENT FOR EXPENSES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PATRICK MCCANN MD | ||||||||||||||
| ER MEDICAL DIRECTOR | $237,536 | $0 | $0 | $0 | $0 | $0 | $7,344 | $0 | $27,705 | $0 | $272,585 | $0 | $0 | $0 |
| ANNE MENTELE CRNA | ||||||||||||||
| CERT. NURSE ANESTHETIST | $162,982 | $0 | $0 | $0 | $0 | $0 | $4,716 | $0 | $27,705 | $0 | $195,403 | $0 | $0 | $0 |
| TIMOTHY SCHMIDT CRNA | ||||||||||||||
| CERT. NURSE ANESTHETIST | $159,718 | $0 | $0 | $0 | $0 | $0 | $5,009 | $0 | $27,705 | $0 | $192,432 | $0 | $0 | $0 |
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 | WI HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 391337855 | BondIssuerEIN |
| Bond Issued | 2014-10-23 | BondIssuedDt |
| Issue Price | $21,200,000 | IssuePriceAmt |
| Purpose | CONSTRUCTING REPLACEMENT HOSPITAL | 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 |
| Total Proceeds | $21,200,000 | TotalProceedsAmt |
| Capitalized Interest | $328,189 | CapitalizedInterestAmt |
| Issuance Costs From Proceeds | $546,865 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $579,078 | CapitalExpendituresAmt |
| Unspent | $19,745,868 | UnspentAmt |
| Substantial Completion | 2017 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | 0 | 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 | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | 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 | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | 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 | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE BOARD PRESIDENT, VICE-PRESIDENT, SECRETARY, TREASURER. THE EXECUTIVE COMMITTEE SHALL HAVE AN EXERCISE AND POWER AND AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OF DIRECTORS AND WITH THE UNDERSTANDING THAT ALL MATTERS OF MAJOR IMPORTANCE WILL BE REFERRED TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 3 | SPOONER HEALTH SYSTEM CONTRACTS WITH HEALTHTECH MANAGEMENT SERVICES TO PROVIDE MANAGEMENT SERVICES. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE RETURN IS REVIEWED BY MANAGEMENT BEFORE BEING FORWARDED TO THE BOARD OF DIRECTORS. AT THE BOARD OF DIRECTORS MEETING, THE 990 IS REVIEWED WITH BOARD MEMBERS WHO APPROVE IT. THE 990 IS THEN FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | IT IS THE POLICY OF SPOONER HEALTH SYSTEM THAT ALL POTENTIAL CONFLICTS OF INTEREST SHOULD BE IDENTIFIED BY ANY OFFICER, BOARD MEMBER, OR KEY EMPLOYEE OF THE ORGANIZATION ON AN ANNUAL BASIS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. THE PERSON WITH THE CONFLICT SHALL LEAVE MEETINGS DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,323,364. MANAGEMENT AND GENERAL EXPENSES 45,388. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,368,752. |
| FORM 990, PART XI, LINE 9: | CAPITAL REPAIR FUND -637,500. REVERSAL OF PRIOR YEAR GRANT TO BLCS THAT NEVER GOT PAID 60,000. |