BEAVER DAM COMMUNITY HOSPITALS INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- BEAVER DAM COMMUNITY HOSPITALS INC (EIN 39-1157876)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-13
- IRS object ID
- 201631349349300148
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-13T09:39:35-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | 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 | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391157876 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEAVER DAM COMMUNITY HOSPITALS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BEAV | BusinessNameControlTxt |
| Phone | 9208874041 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 707 SOUTH UNIVERSITY AVENUE | AddressLine1Txt |
| City | BEAVER DAM | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53916 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KIMBERLY JM MILLER | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 9208874041 | PhoneNum |
| Signature | 2016-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KACIE MCEWEN | PreparerPersonNm |
| PTIN | P01599614 | PTIN |
| Phone | 6123764500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KIMBERLY JM MILLER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 707 SOUTH UNIVERSITY AVENUE | AddressLine1Txt |
| City | BEAVER DAM | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53916 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $108,133,092 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BDCH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | DELIVER EXCELLENCE ACROSS A CONTINUUM OF SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 1059 | TotalEmployeeCnt |
| Total Volunteers | 234 | TotalVolunteersCnt |
| Total Gross UBI | $2,237,402 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $229,702 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,600 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $103,112,985 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $98,554,361 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,179,667 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,299,739 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,768,251 | PYOtherRevenueAmt |
| CY Other Revenue | $5,300,699 | CYOtherRevenueAmt |
| PY Total Revenue | $111,290,605 | PYTotalRevenueAmt |
| CY Total Revenue | $106,161,399 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $125,819 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $107,583 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $49,855,375 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $47,733,053 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $54,553,438 | PYOtherExpensesAmt |
| CY Other Expenses | $49,543,881 | CYOtherExpensesAmt |
| PY Total Expenses | $104,534,632 | PYTotalExpensesAmt |
| CY Total Expenses | $97,384,517 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,755,973 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $8,776,882 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $179,217,909 | TotalAssetsBOYAmt |
| Total Assets EOY | $181,703,241 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $94,209,848 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $91,524,820 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $85,008,061 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $90,178,421 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | BE THE REGIONAL DESTINATION FOR HEALTH CARE BY DELIVERING UNPRECEDENTED QUALITY, SAFETY, AND SERVICE AT A COMPETITIVE PRICE BY DELIVERING EXCELLENCE ACROSS A CONTINUUM OF SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $52,459,524 | ExpenseAmt |
| Grant | $103,233 | GrantAmt |
| Revenue | $73,524,623 | RevenueAmt |
| Desc | THE HOSPITAL PROVIDES INPATIENT AND OUTPATIENT SERVICES TO ITS PATIENTS. IN THE FISCAL YEAR ENDED 6/30/2015, THERE WERE 4,545 PATIENT DAYS, 1,665 ADMISSIONS, 330 BIRTHS, 709 NURSERY DAYS, AND 94,309 OUTPATIENT VISITS. THERE ARE MEDICAL/SURGICAL, TELEMETRY, INTENSIVE CARE, OBSTETRICS, AND NURSERY UNITS ON THE INPATIENT FLOORS. THERE IS AN EMERGENCY ROOM, URGENT CARE, A SURGERY CENTER, REHABILITATION CENTER, PAIN CLINIC, OUTPATIENT MEDICAL ONCOLOGY CLINIC, MEDICAL IMAGING, PHARMACY DEPARTMENT AND A WOUND CENTER. THESE SERVICES ALL GENERATE NET PATIENT REVENUE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,979,730 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $9,609,374 | RevenueAmt |
| Desc | HILLSIDE MANOR IS A 115 BED NURSING HOME CERTIFIED BY MEDICARE/MEDICAID AND OFFERS SKILLED NURSING, COMPREHENSIVE REHABILITATION, AND AN EXTENSIVE ACTIVITIES PROGRAM. TOTAL PATIENT DAYS FOR THE FISCAL YEAR ENDED 6/30/2015 WERE 36,393. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,373,455 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $4,209,219 | RevenueAmt |
| Desc | THE HOMECARE PROGRAM INCLUDES HOME HEALTH AND HOSPICE SERVICES. HOME HEALTH OFFERS SKILLED NURSING, PERSONAL CARE, AND REHABILITATION TO PATIENTS IN THEIR OWN HOME. THERE WERE 12,822 HOMECARE VISITS FOR THE FISCAL YEAR ENDING 6/30/2015. THE HOSPICE PROGRAM PROVIDES SUPPORT TO PATIENTS WHO ARE TERMINALLY ILL. THE HOSPICE PROGRAM HAS 13,291 TOTAL DAYS FOR THE FISCAL YEAR ENDING 6/30/2015. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $11,738,718 | ExpenseAmt |
| Grant | $4,350 | GrantAmt |
| Revenue | $13,837,629 | RevenueAmt |
| Desc | OTHER PROGRAMS INCLUDE PHYSICIAN CLINICS, OCCUPATIONAL HEALTH, DAYCARE PROGRAM, ASSISTED LIVING PROGRAM, REFERENCE LABORATORY, HOMEMAKER PROGRAM, AND SPORTS FITNESS FACILITY. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $11,738,718 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $4,350 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $13,837,629 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $73,551,427 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | 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 | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 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 | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 52 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1059 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | 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 | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DONNA HUTCHINSON | PersonNm |
| Phone | 9208874041 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 707 SOUTH UNIVERSITY AVENUE | AddressLine1Txt |
| City | BEAVER DAM | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53916 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JIM KIRSH | |||||||||
| CHAIRPERSON | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| KARLA CHASE | |||||||||
| VICE-CHAIRPERSON | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | 1.00 | ||
| SUE SUTTER | |||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| DOUG MATHISON | |||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| MARSHA BORLING | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| LISA DAVIDSON | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| WADE FLETCHER | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | 3.00 | |||
| DAN LANDDECK MD | |||||||||
| BOARD MEMBER UNTIL FEBRUARY 2015 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| TERRY O'CONNER | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| RICK TOVAR MD | |||||||||
| BOARD MEMBER/CHIEF OF STAFF | 1.00 | Yes (X) | $32,780 | $0 | $0 | ||||
| KIMBERLY MILLER | |||||||||
| PRESIDENT & CEO | 40.00 | Yes (X) | Yes (X) | $399,276 | $0 | $44,127 | 3.00 | ||
| DONNA HUTCHINSON | |||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $223,053 | $0 | $14,105 | 3.00 | |||
| MIKE MURPHY | |||||||||
| CHIEF PATIENT CARE OFFICER | 40.00 | Yes (X) | $187,892 | $0 | $34,504 | ||||
| DAVID CORSO | |||||||||
| CHIEF OPERATIONS OFFICER | 40.00 | Yes (X) | $175,556 | $0 | $13,631 | ||||
| JULIA WRIGHT | |||||||||
| CHIEF MEDICAL OFFICER | 40.00 | Yes (X) | $307,828 | $0 | $27,661 | ||||
| DON ANDERSON | |||||||||
| DIRECTOR OF PHARMACY | 40.00 | $151,097 | $0 | $28,716 | Yes (X) | ||||
| ELZBIETA OSTROMECKI | |||||||||
| HOSPITALIST | 40.00 | $296,225 | $0 | $37,515 | Yes (X) | ||||
| BERT CALLAHAN | |||||||||
| ORTHOPEDICS & SPORTS MEDICINE PHYSICIAN | 40.00 | $901,874 | $0 | $26,902 | Yes (X) | ||||
| RASCHELLE SCHOWENGERDT | |||||||||
| OBGYN PHYSICIAN | 40.00 | $140,043 | $0 | $0 | Yes (X) | ||||
| JOHN DAVID | |||||||||
| HOSPITALIST | 40.00 | $189,084 | $0 | $17,215 | Yes (X) | ||||
| MELISSA GREER | |||||||||
| FAMILY PRACTICE PHYSICIAN | 40.00 | $199,582 | $0 | $9,069 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,204,290 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $253,445 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 29 | 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 |
|---|---|---|---|---|---|
| DEDICATED COMPUTING LLC | |||||
| N26 W23880 COMMERCE CIRCLE | WAUKESHA | WI | 53188 | IT SUPPORT AND CONSULTING | $844,311 |
| GREENFIELD REHABILITATION AGENCY | |||||
| 7517 W COLDSPRING ROAD | GREENFIELD | WI | 53220 | REHABILITATION SERVICES | $840,593 |
| COMPHEALTH ASSOCIATES INC | |||||
| PO BOX 972651 | DALLAS | TX | 75397 | LOCUMS | $783,514 |
| HALL RENDER KILLIAN | |||||
| 39778 TREASURY CENTER | CHICAGO | IL | 60691 | LEGAL SERVICES | $662,823 |
| SODEXO INC & ASSOCIATES | |||||
| 47880 PAYSPHERE CIRCLE | CHICAGO | IL | 60674 | FACILITIES MAINTENANCE | $492,169 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 18 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $2,000 | RelatedOrganizationsAmt |
| All Other Contributions | $4,600 | AllOtherContributionsAmt |
| Total Contributions | $6,600 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REVENUES | 621300 | $95,464,786 | $94,850,937 | $613,849 |
| ASSISTED CARE PROGRAM | 623990 | $2,097,161 | $2,097,161 | |
| OCC HEALTH PROGRAM | 621990 | $487,368 | $487,368 | |
| OTHER | 713940 | $312,720 | $312,720 | |
| HOMEMAKER SERVICES | 812900 | $192,326 | $192,326 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $98,554,361 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,550,997 | TotalRevenueColumnAmt |
| Exclusion | $1,550,997 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $110,891 | TotalRevenueColumnAmt |
| Exclusion | $110,891 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,655,995 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,919,091 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $736,904 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $736,904 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $265,480 | UnrelatedBusinessRevenueAmt |
| Exclusion | $471,424 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $677,634 | SecuritiesAmt |
| Other | $11,025 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $50,808 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $677,634 | SecuritiesAmt |
| Other | -$39,783 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $637,851 | TotalRevenueColumnAmt |
| Exclusion | $637,851 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $5,488 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $1,794 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,694 | TotalRevenueColumnAmt |
| Exclusion | $3,694 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| MISCELLANEOUS INCOME | 900099 | $1,815,992 | $1,815,992 | ||
| DAYCARE REVENUE | 624410 | $1,359,769 | $209,632 | $1,150,137 | |
| FOOD SERVICE | 722320 | $767,870 | $767,870 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $616,470 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $600,860 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $15,610 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,560,101 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $106,161,399 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $100,374,670 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,237,402 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,542,727 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,350 | TotalAmt |
| Program Services | $47,350 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,233 | TotalAmt |
| Program Services | $60,233 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,577,681 | TotalAmt |
| Management And General | $1,577,681 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,624,351 | TotalAmt |
| Program Services | $29,868,922 | ProgramServicesAmt |
| Management And General | $5,755,429 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $600,737 | TotalAmt |
| Program Services | $519,181 | ProgramServicesAmt |
| Management And General | $81,556 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,407,601 | TotalAmt |
| Program Services | $6,196,379 | ProgramServicesAmt |
| Management And General | $1,211,222 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,522,683 | TotalAmt |
| Program Services | $2,036,190 | ProgramServicesAmt |
| Management And General | $486,493 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $761,899 | TotalAmt |
| Management And General | $761,899 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,467 | TotalAmt |
| Management And General | $101,467 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,394 | TotalAmt |
| Management And General | $39,394 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,484,865 | TotalAmt |
| Program Services | $6,996,793 | ProgramServicesAmt |
| Management And General | $3,488,072 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $408,201 | TotalAmt |
| Program Services | $3,505 | ProgramServicesAmt |
| Management And General | $404,696 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,479,620 | TotalAmt |
| Program Services | $1,553,059 | ProgramServicesAmt |
| Management And General | $926,561 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,195,163 | TotalAmt |
| Program Services | $134,279 | ProgramServicesAmt |
| Management And General | $2,060,884 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,622,243 | TotalAmt |
| Program Services | $696,439 | ProgramServicesAmt |
| Management And General | $925,804 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,247 | TotalAmt |
| Program Services | $248,127 | ProgramServicesAmt |
| Management And General | $101,120 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,886 | TotalAmt |
| Program Services | $84,968 | ProgramServicesAmt |
| Management And General | $94,918 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,850,210 | TotalAmt |
| Program Services | $2,186,459 | ProgramServicesAmt |
| Management And General | $663,751 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,607,915 | TotalAmt |
| Program Services | $6,194,255 | ProgramServicesAmt |
| Management And General | $1,413,660 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $409,280 | TotalAmt |
| Program Services | $63,393 | ProgramServicesAmt |
| Management And General | $345,887 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES/DRUGS | $11,717,788 | $11,693,010 | $24,778 |
| BAD DEBT EXPENSE | $3,558,845 | $3,558,845 | |
| ASSESSMENT/USER FEES | $2,583,124 | $277,500 | $2,305,624 |
| FOOD | $849,918 | $843,865 | $6,053 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,344,816 | TotalAmt |
| Program Services | $288,675 | ProgramServicesAmt |
| Management And General | $1,056,141 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,384,517 | TotalAmt |
| Program Services | $73,551,427 | ProgramServicesAmt |
| Management And General | $23,833,090 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,554 | BOYAmt |
| EOY | $58,619 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,163,270 | BOYAmt |
| EOY | $7,526,192 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,896,752 | BOYAmt |
| EOY | $11,518,718 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,090,465 | BOYAmt |
| EOY | $2,095,208 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,300,457 | BOYAmt |
| EOY | $1,307,795 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $169,288,812 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $78,281,750 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,834,537 | BOYAmt |
| EOY | $91,007,062 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,684,696 | BOYAmt |
| EOY | $64,827,496 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,206,178 | BOYAmt |
| EOY | $3,362,151 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $179,217,909 | BOYAmt |
| EOY | $181,703,241 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,435,343 | BOYAmt |
| EOY | $8,716,141 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $142,577 | BOYAmt |
| EOY | $147,511 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,483,388 | BOYAmt |
| EOY | $62,442,142 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $617,430 | BOYAmt |
| EOY | $425,249 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,008,839 | BOYAmt |
| EOY | $11,684,285 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,522,271 | BOYAmt |
| EOY | $8,109,492 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,209,848 | BOYAmt |
| EOY | $91,524,820 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,354,190 | BOYAmt |
| EOY | $87,347,137 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,653,871 | BOYAmt |
| EOY | $2,831,284 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,008,061 | BOYAmt |
| EOY | $90,178,421 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $179,217,909 | BOYAmt |
| EOY | $181,703,241 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $8,776,882 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,541,583 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$2,064,939 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $2,944 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $2,944 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | BDCH PAYS ANNUAL MEMBERSHIP FEES TO WISCONSIN HOSPITAL ASSOCIATION (WHA). A PORTION OF THESE MEMBERSHIP FEES (12% IN 2014) WERE USED BY WHA FOR LOBBYING ON BEHALF OF THE ASSOCIATION MEMBERS | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,249,379 | OtherCostOrOtherBasisAmt |
| Book Value | $3,249,379 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $112,089,183 | OtherCostOrOtherBasisAmt |
| Depreciation | $39,045,059 | DepreciationAmt |
| Book Value | $73,044,124 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $760,349 | OtherCostOrOtherBasisAmt |
| Depreciation | $368,079 | DepreciationAmt |
| Book Value | $392,270 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $52,730,141 | OtherCostOrOtherBasisAmt |
| Depreciation | $38,868,612 | DepreciationAmt |
| Book Value | $13,861,529 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $459,760 | OtherCostOrOtherBasisAmt |
| Book Value | $459,760 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $91,007,062 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| OBLIGATION UNDER CAPITAL LEASE | $526,573 |
| ACCRUED PENSION LIABILITY | $7,154,846 |
| ESTIMATED SETTLEMENTS DUE TO THIRD-PARTY PAYORS | $428,073 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $8,109,492 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | RESIDENT TRUST FUNDS ARE FUNDS THAT ARE THE RESIDENTS' THAT ARE DEPOSITED IN A SEPARATE BANK ACCOUNT. THESE FUNDS ARE TRACKED SEPARATELY FROM BDCH'S FUNDS AND BELONG TO THE RESIDENTS. SECURITY DEPOSITS ARE DEPOSITS PAID TO BDCH UPON ENTERING INTO A RENTAL AGREEMENT FOR CBRF RESIDENTS AND ARE DUE BACK TO THE TENANTS UPON TERMINATION OF THEIR RENTAL AGREEMENT. |
| PART X, LINE 2: | ALL OF THE ENTITIES WITHIN THE CORPORATION ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE, EXCEPT BDMCB2, ACS BD DEVELOPMENT, AND DHE. BDMCB2, ACS BD DEVELOPMENT, AND DHE ARE ALL LIMITED LIABILITY COMPANIES AND ARE NOT DIRECTLY SUBJECT TO TAXATION. THEY HAVE ELECTED TO BE TREATED AS DISREGARDED ENTITIES FOR FEDERAL INCOME TAX PURPOSES. INCOME AND LOSSES OF THE COMPANIES ARE PASSED THROUGH TO AND REPORTED FOR INCOME TAX PURPOSES BY THE CORPORATION. THE CORPORATION FOLLOWS THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION GUIDANCE ON INCOME TAXES, ACCOUNTING FOR UNCERTAINTIES IN INCOME TAXES, WHICH ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THIS GUIDANCE, THE CORPORATION MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. UNRELATED BUSINESS TAXABLE INCOME IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ALSO ADDRESSES DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES, AND ACCOUNTING IN INTERIM PERIODS. AT JUNE 30, 2015 AND 2014, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES. |
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 |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $950,142 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $950,142 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01010 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,225,518 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,292,625 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,932,893 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05260 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,175,660 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,292,625 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,883,035 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06270 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $105,716 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $105,716 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,442 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,442 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,837 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $23,837 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $133,995 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $133,995 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,309,655 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,292,625 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,017,030 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06410 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,558,845 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $462,650 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $19,117,741 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $23,852,364 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$4,734,623 | 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 | BEAVER DAM COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 707 SOUTH UNIVERSITY AVENUE | AddressLine1Txt |
| City | BEAVER DAM | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53916 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.BDCH.COM | WebsiteAddressTxt |
| State License | 199 | 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 | BEAVER DAM COMMUNITY HOSPITAL | 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 |
| 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | 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.BDCH.COM/ABOUT-US.ASPX | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.BDCH.COM/ABOUT-US.ASPX | StrategyWebsiteURLTxt |
| 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 | 300.000000000000 | 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 |
| 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 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 |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| 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 |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BEAVER DAM COMMUNITY HOSPITAL | PART V, SECTION B, LINE 5: BDCH GATHERED QUALITATIVE INFORMATION AND PERSPECTIVES ON COMMUNITY HEALTH NEEDS THROUGH ONE-ON-ONE AND SMALL GROUP INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS. BDCH GATHERED INFORMATION FROM THE FOLLOWING SPECIFIED GROUPS WITHIN THE COMMUNITY:- PEOPLE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH - FEDERAL, TRIBAL, REGIONAL, STATE OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES, WITH CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY - LEADERS, REPRESENTATIVES OR MEMBERS OF MEDICALLY UNDERSERVED POPULATIONS- LEADERS, REPRESENTATIVES OR MEMBERS OF LOW-INCOME POPULATIONS - LEADERS, REPRESENTATIVES OR MEMBERS OF MINORITY POPULATIONS SELECT INDIVIDUALS FROM THE FOLLOWING ORGANIZATIONS PARTICIPATED BY CONTRIBUTING THEIR PERSPECTIVES, OPINIONS, AND OBSERVATIONS:- DODGE COUNTY HUMAN SERVICES AND HEALTH DEPARTMENT- JEFFERSON COUNTY HEALTH DEPARTMENT - JEFFERSON COUNTY HUMAN SERVICES DEPARTMENT- CHURCH HEALTH SERVICES- HILLSIDE MANOR- WAYLAND ACADEMY- THE AGING AND DISABILITY RESOURCE CENTER- BEAVER DAM COMMUNITY HOSPITALS, INC. - CITY OF WATERTOWN AND DODGE COUNTY |
| BEAVER DAM COMMUNITY HOSPITAL | PART V, SECTION B, LINE 6A: BDCH BEGAN ITS HEALTH NEEDS ASSESS PROCESS BY PARTICIPATING IN THE DODGE JEFFERSON HEALTHIER COMMUNITY PARTNERSHIP ("THE DJHCP"). THE DJHCP IS A COLLABORATIVE GROUP INCLUDING THE FOLLOWING ORGANIZATIONS: BEAVER DAM COMMUNITY HOSPITAL, FORT HEALTHCARE, UW HEALTH PARTNERS WATERTOWN REGIONAL MEDICAL CENTER, DODGE COUNTY HUMAN SERVICES AND HEALTH DEPARTMENT, JEFFERSON COUNTY HEALTH DEPARTMENT, WATERTOWN DEPARTMENT OF PUBLIC HEALTH, DODGE-JEFFERSON HEALTHIER COMMUNITY PARTNERSHIP, INC. IN ADDITION TO OUR INVOLVEMENT IN THE THE DJHCP COMMUNITY HEALTH ASSESSMENT PROCESS, BDCH CONTRACTED WITH AN INDEPENDENT ACCOUNTNG AND CONSULTING FIRM TO COMPLETE THEIR OWN COMMUNITY HEALTH NEEDS ASSESSMENT. |
| BEAVER DAM COMMUNITY HOSPITAL | PART V, SECTION B, LINE 7D: BDCH MADE ITS COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION POLICY AVAILABLE ON THEIR WEBSITE AT WWW.BDCH.COM/ABOUT-US.ASPX.IN ADDITION TO POSTING THE CHNA ON OUR WEBSITE, WE HAVE COMMUNICATED THE RESULTS OF THE SURVEY QUITE WIDELY. THIS INCLUDES AN ARTICLE IN OUR 2013 ANNUAL REPORT WHICH WENT TO 50,000 HOUSEHOLDS. THE ANNUAL REPORT IS ON-LINE AND A DIRECT LINK TO THE STUDY IS INCLUDED. COPIES ARE AVAILABLE IN ADMINISTRATION AND MARKETING AND AT VARIOUS LOCATIONS THROUGHOUT THE HOSPITAL FOR ANYONE WHO WANTS A COPY. A LOCAL PUBLICATION PUBLISHED AN ARTICLE WHICH COMMUNICATED THE RESULTS OF THE CHNA. CHNA RESULTS ARE ALSO COMMUNICATED VIA PRESENTATIONS AT LOCAL EVENTS SUCH AS SENIOR CENTER PRESENTATIONS AND CEO CONVERSATIONS, CHAMBER OF COMMERCE EVENTS AND LOCAL CIVIC AND COMMUNITY ORGANIZATIONS. THIS IS IN ADDITION TO PUBLICIZING TO OUR OWN EMPLOYEES AND PHYSICIANS. |
| BEAVER DAM COMMUNITY HOSPITAL | PART V, SECTION B, LINE 11: BECAUSE OF LIMITED RESOURCES, BDCH CANNOT RESPOND EFFECTIVELY TO EVERY IDENTIFIED HEALTH NEED. BDCH HAS CHOSEN ITS RESPONSES BASED ON ANALYSIS OF ITS RESOURCES, ITS MISSION, IT EXISTING SPECIALTIES, COMMUNITY PRIORITIES AND EXISTING COMMUNITY RESOURCES. BDCH CHOSE TO FOCUS ITS RESOURCES ON ITS PRIMARY COMMUNITY NEEDS - NUTRITION AND PHYSICAL ACTIVITY. |
| BEAVER DAM COMMUNITY HOSPITAL | PART V, SECTION B, LINE 22D: THE AMOUNT CHARGED FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE PROVIDED TO INDIVIDUALS ELIGIBLE FOR ASSISTANCE UNDER THE COMMUNITY CARE PROGRAM IS LIMITED TO NOT MORE THAN THE AMOUNT GENERALLY BILLED TO INDIVIDUALS HAVING INSURANCE COVERING SUCH CARE. THE AMOUNT GENERALLY BILLED IS CALCULATED USING THE LOOK-BACK METHOD ON AN ANNUAL BASIS USING BOTH MEDICARE AND MEDICAID RATES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 16 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| HILLSIDE MANOR | ||||
| 803 SOUTH UNIVERSITY AVENUE | BEAVER DAM | WI | 53916 | SKILLED NURSING FACILITY |
| BEAVER DAM REFERENCE LAB | ||||
| 707 SOUTH UNIVERSITY AVENUE | BEAVER DAM | WI | 53916 | REFERENCE LAB |
| HILLSIDE HOMECARE AND HOSPICE | ||||
| 709 SOUTH UNIVERSITY AVENUE | BEAVER DAM | WI | 53916 | HOME HEALTH AGENCY |
| REMEMBRANCE HOME | ||||
| 1810 NORTH SPRING STREET | BEAVER DAM | WI | 53916 | DEMENTIA SPECIFIC COMMUNITY BASED RESIDENTIAL FACILITY |
| BEAVER DAM MEDICAL CLINIC | ||||
| 109 WARREN STREET | BEAVER DAM | WI | 53916 | PHYSICIAN CLINIC |
| BEAVER DAM MEDICAL CLINIC | ||||
| 148 WARREN STREET | BEAVER DAM | WI | 53916 | PHYSICIAN CLINIC |
| BEAVER DAM OBGYN CLINIC | ||||
| 130 WARREN STREET | BEAVER DAM | WI | 53916 | PHYSICIAN CLINIC |
| EAGLES WINGS | ||||
| 408 STONE STREET | BEAVER DAM | WI | 53916 | COMMUNITY BASED RESIDENTIAL FACILITY |
| WAUPUN MEDICAL CLINIC | ||||
| 180 GATEWAY DRIVE | WAUPUN | WI | 53963 | PHYSICIAN CLINIC |
| COLUMBUS MEDICAL CLINIC | ||||
| 1580 WEST JAMES STREET | COLUMBUS | WI | 53925 | PHYSICIAN CLINIC |
| BEAVER DAM SPORTS MEDICAL CLINIC | ||||
| 707 SOUTH UNIVERSITY AVENUE | BEAVER DAM | WI | 53916 | PHYSICIAN CLINIC |
| JUNEAU MEDICAL CLINIC | ||||
| 420 WEST NORTH STREET | BEAVER DAM | WI | 53916 | PHYSICIAN CLINIC |
| HORICON MEDICAL CLINIC | ||||
| 610 WASHINGTON STREET | HORICON | WI | 64501 | PHYSICIAN CLINIC |
| SLEEP LAB | ||||
| 919 UNIVERSITY AVE | BEAVER DAM | WI | 53916 | SLEEP LAB |
| UROLOGY CLINIC | ||||
| 130 WARREN STREET | HORICON | WI | 53032 | PHYSICIAN CLINIC |
| RHEUMATOLOGY CLINIC | ||||
| 1580 WEST JAMES STREET | COLUMBUS | WI | 53925 | PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | IN ADDITION TO ITS COMMUNITY BENEFITS REPORT WHICH IT PREPARES, BDCH PREPARES AN ANNUAL REPORT EACH YEAR THAT IS DISTRIBUTED TO MEMBERS OF THE COMMUNITIES THAT WE SERVE. WITHIN THE ANNUAL REPORT IS A SECTION REGARDING COMMUNITY BENEFITS. |
| PART I, LINE 7: | CHARITY CARE IS DETERMINED BY UTILIZING THE TOTAL AMOUNT FROM THE PATIENT BILLING SYSTEM THAT IS WRITTEN OFF USING THE CHARITY CARE ALLOWANCE CHARGE CODES FROM THE CHARGEMASTER. THIS AMOUNT TIES TO THE NUMBER THAT IS REPORTED IN THE AUDITED FINANCIAL STATEMENTS FOR THE FISCAL YEAR ENDED 6/30/15. THE TOTAL CHARITY CARE AMOUNT REPORTED ON LINE 7A COLUMN (C) IS REDUCED TO COST BY APPLYING BDCH'S COST TO CHARGE RATES AS CALCULATED ON IRS SCHEDULE H - WORKSHEET 2. |
| PART I, LINE 7G: | BDCH DOES NOT HAVE SUFFICIENT INFORMATION AT THIS TIME TO DETERMINE IF SUBSIDIZED SERVICES EXIST BASED ON THE DEFINITION AND CALCULATIONS REQUIRED BY THE IRS AND IS WORKING TO PROVIDE SUCH INFORMATION. |
| PART I, LN 7 COL(F): | THE AMOUNT OF BAD DEBT EXPENSES THAT WAS EXCLUDED FROM THE CALCULATION TO DETERMINE THE NET COMMUNITY BENEFIT EXPENSES AS A PERCENT OF TOTAL EXPENSES WAS $3,558,845. |
| PART III, LINE 2: | THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 IS THE AMOUNT OF PATIENT RECEIVABLE THAT WAS DEEMED UNCOLLECTIBLE DURING FY2015. BDCH BELIEVES THAT ITS CHARITY CARE AND RELATED COMMUNITY BENEFIT IS UNDERESTIMATED DUE TO PATIENTS THAT MAY POTENTIALLY QUALIFY FOR CHARITY CARE BUT CHOOSE NOT TO APPLY FOR IT. IN ADDITION, THERE IS ADDITIONAL BAD DEBT EXPENSE DUE TO CHARITY CARE APPLICATIONS THAT ARE MISSING INFORMATION AND ARE THEREFORE INCOMPLETE. BAD DEBT IN FY 2015 IS $3,558,845. |
| PART III, LINE 3: | TO CALCULATE THE CHARITY-ELIGIBLE COST OF ACCOUNTS WRITTEN OFF AS BAD DEBT EXPENSE ON LINE 3, THE PERCENT OF POPULATION BELOW POVERTY LEVEL WAS DETERMINED FROM U.S. CENSUS BUREAU INFORMATION. THIS PERCENTAGE WAS MULTIPLIED BY THE COST OF THE AMOUNT WRITTEN OFF TO BAD DEBT WHICH PRODUCED THE AMOUNT OF CHARGES WRITTEN OFF TO BAD DEBT THAT COULD BE ASSUMED TO BE CHARITY-ELIGIBLE. |
| PART III, LINE 4: | PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE CORPORATION 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 CORPORATION 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 CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS WHEN RECEIVED. A RECEIVABLE IS CONSIDERED TO BE PAST DUE IF ANY PORTION OF THE RECEIVABLE BALANCE IS OUTSTANDING FOR MORE THAN 180 DAYS. INTEREST IS NOT CHARGED ON PAST DUE RECEIVABLE BALANCES. |
| PART III, LINE 8: | THE ALLOWABLE MEDICARE COST ON PART III, LINE 6 IS DETERMINED USING THE FY 2015 FILED MEDICARE COST REPORT. THE REIMBURSEMENT FROM MEDICARE IS DEDUCTED FROM THE ESTIMATED COST TO DETERMINE THE ESTIMATED SHORTFALL FROM THE MEDICARE PROGRAM. BDCH RECOGNIZES THAT THE ESTIMATED SHORTFALL IS ACTUALLY GREATER THAN WHAT IS INCLUDED IN PART III, LINE 7 DUE TO THE NON-ALLOWABLE COSTS PER THE MEDICARE COST REPORT. THIS SHORTFALL OF $4,734,623 IS NOT CLASSIFIED AS COMMUNITY BENEFIT. HOWEVER, BDCH BELIEVES IT IS AN IMPORTANT CONTRIBUTION MADE BY THE HOSPITAL TO SUPPORT ITS MISSION OF DELIVERING EXCELLENCE ACROSS A CONTINUUM OF SERVICES, EVEN IF WE ARE NOT COMPENSATED FULLY FOR DOING SO. IN ADDITION, MANY OF THESE PATIENTS WOULD QUALIFY FOR MEDICAID AS SEVERAL PATIENTS CARRY IT AS A SECONDARY PLAN, SO THEREFORE, IF THE MEDICARE PROGRAM DID NOT EXIST, MEDICAID WOULD BE THE PRIMARY INSURANCE FOR MANY PATIENTS, WHICH IS CONSIDERED TO BE COMMUNITY BENEFIT. |
| PART III, LINE 9B: | BDCH MAKES EVERY EFFORT TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR CHARITY CARE OR OTHER FINANCIAL ASSISTANCE. AS DESCRIBED IN PART VI, QUESTION 3, BDCH HAS PROCESSES IN PLACE TO INFORM PATIENTS OF OUR CHARITY CARE POLICY. IF THE PATIENT'S INCOME LEVEL QUALIFIES THEM FOR CHARITY CARE, THE FULL AMOUNT OF THEIR ACCOUNT BALANCE IS WRITTEN OFF AS CHARITY CARE. IF THE PATIENT DOES NOT AUTOMATICALLY QUALIFY FOR CHARITY CARE, THEY CAN PROVIDE ADDITIONAL INCOME INFORMATION TO DETERMINE IF THEY QUALIFY FOR FULL OR PARTIAL CHARITY CARE WRITE-OFFS. IF ONLY A PARTIAL AMOUNT IS WRITTEN OFF PER POLICY, THEN THE PATIENT IS RESPONSIBLE FOR THE REMAINING BALANCE. THE PATIENT HAS THE OPTION TO MAKE INSTALLMENT PAYMENTS WITH NO INTEREST. IN THE EVENT THAT THE PATIENT DEFAULTS ON THEIR INSTALLMENT PAYMENTS OR DOES NOT COOPERATE WITH BDCH'S COLLECTION EFFORTS, THE ACCOUNT WILL BE SENT TO A COLLECTION AGENCY. |
| PART VI, LINE 2: | EVERY FIVE YEARS, THE HEALTH DEPARTMENTS OF DODGE COUNTY AND JEFFERSON COUNTY AND THE CITY OF WATERTOWN CONDUCT A JOINT COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMPILE A REPORT CONTAINING AN ANALYSIS OF THE QUALITATIVE AND QUANTITATIVE INFORMATION GATHERED FROM SEVERAL SOURCES INCLUDING COMMUNITY FOCUS GROUPS, THE US CENSUS BUREAU, AND THE BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM, AMONG OTHERS. THE REPORT INCORPORATES DATA TO ADDRESS ALL ELEVEN HEALTH PRIORITIES IN THE WISCONSIN STATE HEALTH PLAN. BEAVER DAM COMMUNITY HOSPITALS, INC. HAS OBTAINED A COPY OF THE FULL REPORT AND UTILIZES THE INFORMATION TO ASSESS THE HEALTH NEEDS OF OUR COMMUNITY. IN ADDITION, BDCH SUPPORTS CHURCH HEALTH SERVICES, A LOCAL ORGANIZATION COMMITTED TO SERVING LOW INCOME PATIENTS WITH NO INSURANCE, AND MEETS WITH THEM TO ASSESS THE NEEDS OF THE COMMUNITY. |
| PART VI, LINE 3: | PATIENTS REGISTERED AS SELF-PAY PATIENTS ARE ENTERED INTO A PROPENSITY TO PAY SYSTEM AND IF THEIR INCOME IS LESS THAN 300% OF THE FEDERAL POVERTY LEVEL, THEY ARE AUTOMATICALLY DETERMINED TO BE ELIGIBLE FOR CHARITY CARE AND 100% OF THEIR CHARGES ARE WRITTEN OFF. PATIENTS WHO ARE NOT ELIGIBLE FOR CHARITY CARE UNDER THE PROPENSITY TO PAY SYSTEM MAY REQUEST CHARITY CARE OR PARTIAL BALANCE WRITE-OFFS THROUGH FINANCIAL COUNSELORS. |
| PART VI, LINE 4: | BEAVER DAM COMMUNITY HOSPITALS, INC. SERVES THE GREATER DODGE AND COLUMBIA COUNTY REGION. THE HOME SERVICES PROGRAM ALSO TRAVELS TO OUR PATIENTS IN THEIR HOMES UP TO 30 MILES AWAY. THE POPULATION OF THE AREA WE SERVE IS APPROXIMATELY 125,000 PEOPLE. DEMOGRAPHICALLY, ABOUT 22% OF THE POPULATION IS UNDER THE AGE 18, ABOUT 63% IS AGED 18 - 64 AND ABOUT 15% IS AGE 65 AND OLDER. OUR HOSPITAL SERVES PATIENTS OF ALL AGES. ALTHOUGH THE POPULATION IS PRIMARILY CAUCASIAN, THERE IS A GROWING HISPANIC POPULATION. MULTIPLE LANGUAGES ARE SPOKEN IN THE AREA, AND THEREFORE INTERPRETATION SERVICES ARE PROVIDED FOR ALL PATIENTS. |
| PART VI, LINE 5: | BDCH HAS A LONG HISTORY OF SERVING THE COMMUNITY OF BEAVER DAM AND THE SURROUNDING REGION. BDCH HAS CONTINUALLY GROWN SERVICES TO RESPOND TO THE NEEDS OF PATIENTS WE SERVE ACROSS THE REGION IN CARRYING OUT ITS MISSION OF PROVIDING EXCELLENCE ACROSS THE CONTINUUM. BDCH OFFERS SEVERAL HEALTH AND COMMUNITY PROGRAMS AT NO OR LOW COST SUCH AS HEALTH AND SAFETY FAIRS, LACTATION CONSULTATION SERVICES, SUPPORT GROUPS, HEALTH SCREENINGS, MEMORY CARE CLINIC, WELLNESS CLASSES, MEALS ON WHEELS, AND JOINT REPLACEMENT SEMINARS, FOOT CLINIC AND SELF REQUESTED, WALK-IN LAB TESTING AMONG OTHERS.BDCH HAS AN OPEN MEDICAL STAFF, A BOARD COMPRISED OF COMMUNITY MEMBERS, AND USES ITS SURPLUS FUNDS TO REINVEST IN TECHNOLOGY AND PROGRAM SERVICES TO BETTER SERVE ITS PATIENTS. BDCH SUPPORTS CHURCH HEALTH SERVICES, A LOCAL ORGANIZATION COMMITTED TO PROVIDING HEALTH SERVICES TO LOW-INCOME PATIENTS WITHOUT INSURANCE. BDCH PARTICIPATES AS A DROP-OFF SITE FOR SHARPS AND IN THE WISCONSIN HOSPITAL EMERGENCY PREPAREDNESS PLAN WHOSE PURPOSE IS TO MEET A COMMUNITY NEED BY BRINGING ORGANIZATIONS TOGETHER IN THE EVENT OF AN EMERGENCY IN A COLLABORATIVE AND ORGANIZED MANNER. BDCH'S LEADERSHIP STAFF PARTICIPATES IN MANY LOCAL ORGANIZATIONS THROUGHOUT THE REGION. |
| PART VI, LINE 6: | BDCH 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 |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEAVER DAM COMMUNITY HOSPITALS FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 707 SOUTH UNIVERSITY AVENUE | AddressLine1Txt |
| City | BEAVER DAM | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53916 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 391499140 | RecipientEIN |
| IRC Section | 105(C)(3) | IRCSectionDesc |
| Cash Grant | $38,500 | CashGrantAmt |
| Purpose Of Grant | BEAUTY SHOP FUND, KIDSCARE FUND, HOSPICE FUND, AND EMPLOYEE HELPING EMPLOYEE FUND. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | TUITION REIMBURSEMENT | GrantTypeTxt |
| Recipient | 28 | RecipientCnt |
| Cash Grant | $60,232 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE GRANTS GIVEN TO OUTSIDE ORGANIZATIONS WAS GIVEN TO A RELATED ENTITY. FUNDS TRANSFERRED ARE MONITORED THROUGH THE INTERNAL FINANCIAL REPORTING PROCESS AS BOTH ENTITIES ARE UNDER COMMON MANAGEMENT. THE GRANTS GIVEN TO INDIVIDUALS RELATED TO BDCH'S EMPLOYEE TUITION REIMBURSEMENT PROGRAM. THIS PROGRAM PROVIDES ELIGIBLE EMPLOYEES WITH THE OPPORTUNITY TO OBTAIN, MAINTAIN, OR IMPROVE JOB-RELATED OR CAREER-RELATED OBJECTIVES THROUGH PARTICIPATION IN ACADEMIC COURSES AT ACCREDITED COLLEGES AND UNIVERSITIES. THIS PROGRAM IS MONITORED BY HUMAN RESOURCES AND IN ORDER TO RECEIVE THIS BENEFIT, EMPLOYEES MUST GET COURSE APPROVAL PRIOR TO ENROLLMENT, SUCCESSFULLY COMPLETE EACH COURSE WITH A MINIMUM OF A "C" FOR UNDERGRADUATE COURSES OR "B" FOR GRADUATE COURSES, AND SUBMIT A COPY OF AN ITEMIZED RECEIPT WITHIN ONE MONTH FOLLOWING THE END OF CLASS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 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 | Yes (1) | 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 (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KIMBERLY MILLER | ||||||||||||||
| PRESIDENT & CEO | $310,625 | $0 | $52,127 | $0 | $36,524 | $0 | $15,000 | $0 | $29,127 | $0 | $443,403 | $0 | $0 | $0 |
| DONNA HUTCHINSON | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $184,343 | $0 | $18,267 | $0 | $20,443 | $0 | $8,475 | $0 | $5,630 | $0 | $237,158 | $0 | $0 | $0 |
| MIKE MURPHY | ||||||||||||||
| CHIEF PATIENT CARE OFFICER | $167,250 | $0 | $15,937 | $0 | $4,705 | $0 | $6,097 | $0 | $28,407 | $0 | $222,396 | $0 | $0 | $0 |
| DAVID CORSO | ||||||||||||||
| CHIEF OPERATIONS OFFICER | $143,077 | $0 | $14,632 | $0 | $17,847 | $0 | $0 | $0 | $13,631 | $0 | $189,187 | $0 | $0 | $0 |
| JULIA WRIGHT | ||||||||||||||
| CHIEF MEDICAL OFFICER | $289,645 | $0 | $0 | $0 | $18,183 | $0 | $0 | $0 | $27,661 | $0 | $335,489 | $0 | $0 | $0 |
| DON ANDERSON | ||||||||||||||
| DIRECTOR OF PHARMACY | $141,725 | $0 | $6,798 | $0 | $2,574 | $0 | $7,105 | $0 | $21,611 | $0 | $179,813 | $0 | $0 | $0 |
| ELZBIETA OSTROMECKI | ||||||||||||||
| HOSPITALIST | $281,268 | $0 | $13,000 | $0 | $1,957 | $0 | $9,849 | $0 | $27,666 | $0 | $333,740 | $0 | $0 | $0 |
| BERT CALLAHAN | ||||||||||||||
| ORTHOPEDICS & SPORTS MEDICINE PHYSIC | $883,327 | $0 | $0 | $0 | $18,547 | $0 | $0 | $0 | $26,902 | $0 | $928,776 | $0 | $0 | $0 |
| JOHN DAVID | ||||||||||||||
| HOSPITALIST | $173,296 | $0 | $15,467 | $0 | $321 | $0 | $0 | $0 | $17,215 | $0 | $206,299 | $0 | $0 | $0 |
| MELISSA GREER | ||||||||||||||
| FAMILY PRACTICE PHYSICIAN | $184,166 | $0 | $15,000 | $0 | $416 | $0 | $0 | $0 | $9,069 | $0 | $208,651 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 6 | FormAndLineReferenceDesc |
| Explanation | THE BDCH BOARD OF DIRECTORS APPROVED AN INCENTIVE PLAN FOR THE CHIEF EXECUTIVE OFFICER THAT RELATED TO THE FINANCIAL PERFORMANCE, QUALITY, PATIENT SATISFACTION, EMPLOYEE TURNOVER, ORGANIZATIONAL GROWTH AND INDIVIDUAL PERSONAL GOALS. THE INCENTIVE MATRIX WAS APPROVED BY THE BOARD. EACH YEAR THE INCENTIVE COMPENSATION MEASURES ARE CALCULATED AFTER COMPLETION OF THE AUDIT AND PRESENTED TO THE BOARD OF DIRECTORS EXECUTIVE COMPENSATION COMMITTEE WHICH IS COMPRISED OF FIVE INDEPENDENT BOARD MEMBERS FOR APPROVAL. THE EXECUTIVE TEAM INCENTIVE PLAN IS THEN DEVELOPED BASED ON THE CEO'S PLAN AND DIRECTION OF BOARD APPROVED GOALS. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd | CUSIPCUSIPNum |
|---|---|---|---|---|---|---|---|---|
| WISCONSIN HEALTH & EDUCATION FACILITIES AUTHORITY | ||||||||
| A | 391337855 | 2012-05-09 | $25,745,000 | REFINANCE 2004A CALLABLE, 2004B, & 1998 BONDS | 0 | 0 | 0 | |
| WISCONSIN HEALTH & EDUCATION FACILITIES AUTHORITY | ||||||||
| B | 391337855 | 2013-06-25 | $42,864,560 | REFINANCE 2004A BONDS | 0 | 0 | 0 | 97712DBW5 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Bond DefeasedBondDefeasedAmt | In Reserve FundInReserveFundAmt | Capital ExpendituresCapitalExpendituresAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $4,710,000 | $25,745,000 | $312,355 | $25,645,000 | 2006 | Yes (1) | 0 | Yes (1) | Yes (1) | |||
| B | $1,457,418 | $42,864,560 | $646,395 | 2006 | 0 | Yes (1) | Yes (1) | Yes (1) | -$130,440 | $4,352,086 | $5,006,944 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | Yes (1) | Yes (1) | 0 | 0.00050 | 0.00080 | 0.00130 | 0 | 0 | Yes (1) |
| B | 0 | Yes (1) | Yes (1) | Yes (1) | 0 | 0.00050 | 0.00080 | 0.00130 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
| B | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE MEMBERSHIP OF THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRPERSON OF THE BOARD, THE SECRETARY, THE TREASURER, AND THE VICE CHAIRPERSON OF THE BOARD AND SUCH MEMBERS OF THE BOARD OF DIRECTORS AS MAY BE APPOINTED BY THE BOARD OF DIRECTORS. THE COMMITTEE SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF BDCH DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS MAY OVERRULE ANY ACTION PREVIOUSLY TAKEN BY THE EXECUTIVE COMMITTEE. |
| FORM 990, PART VI, SECTION A, LINE 7A | ONE MEMBER OF THE BOARD OF DIRECTORS SHALL BE A PHYSICIAN ELECTED AS THE CHIEF OF STAFF BY THE MEDICAL STAFF OF BDCH. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE HOSPITAL'S CFO PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH BDCH'S CEO BEFORE PRESENTING IT TO THE HOSPITAL'S COMPENSATION COMMITTEE WHICH IS NOW COMPRISED OF FIVE INDEPENDENT BOARD MEMBERS (CHAIRPERSON, VICE-CHAIRPERSON, CHAIRPERSON OF THE FINANCE COMMITTEE, CHAIRPERSON OF THE QUALITY COMMITTEE, AND ONE PAST BOARD CHAIR) FOR REVIEW, DISCUSSION, AND QUESTIONS. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH DIRECTOR, OFFICER AND COMMITTEE MEMBER SIGNS, AS A CONDITION TO SERVING THE CORPORATION IN HIS OR HER RESPECTIVE ROLE AND ANNUALLY THEREAFTER, A STATEMENT AGREEING TO BE BOUND BY THE TERMS OF THE CONFLICT OF INTEREST POLICY. ANY DIRECTOR, OFFICER OR COMMITTEE MEMBER HAVING A FINANCIAL INTEREST OR OTHER INTEREST IN A CONTRACT, MATTER OR OTHER TRANSACTION PRESENTED TO THE BOARD OF DIRECTORS OR A COMMITTEE THEREOF FOR AUTHORIZATION, APPROVAL, OR RATIFICATION SHALL MAKE A PROMPT, FULL AND FRANK DISCLOSURE OF SUCH PERSON'S INTEREST TO THE BOARD OR COMMITTEE PRIOR TO ITS ACTING ON SUCH CONTRACT OR TRANSACTION. SUCH DISCLOSURE SHALL INCLUDE ANY RELEVANT AND MATERIAL FACTS, KNOWN TO SUCH PERSON, ABOUT THE CONTRACT, MATTER OR TRANSACTION WHICH MIGHT REASONABLY BE CONSTRUED TO BE ADVERSE TO THE CORPORATION'S INTEREST. AFTER THE POTENTIALLY CONFLICTED INDIVIDUAL HAS LEFT THE ROOM, THE BOARD OR COMMITTEE TO WHICH SUCH DISCLOSURE IS MADE SHALL THEREUPON DETERMINE, BY MAJORITY VOTE, WHETHER THE DISCLOSURE SHOWS THAT A CONFLICT OF INTEREST EXISTS OR CAN REASONABLY BE CONSTRUED TO EXIST. IF A CONFLICT IS DEEMED TO EXIST, SUCH PERSON SHALL BE INVITED BACK TO PRESENT ANY FACTUAL INFORMATION HE OR SHE DEEMS APPROPRIATE OR TO RESPOND TO QUESTIONS IF SUCH IS REQUESTED OF OTHERS PRESENT. THE INDIVIDUAL SHALL THEN AGAIN LEAVE THE ROOM AND NOT VOTE ON, NOR USE PERSONAL INFLUENCE ON, OR PARTICIPATE (OTHER THAN TO PRESENT FACTUAL INFORMATION TO OR RESPOND TO QUESTIONS AS DESCRIBED ABOVE) IN THE DISCUSSIONS AND DELIBERATIONS WITH RESPECT TO SUCH CONTRACT, MATTER OR TRANSACTIONS. SUCH PERSON MAY BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM AT ANY MEETING WHERE THE CONTRACT, MATTER OR TRANSACTION IS UNDER DISCUSSION OR IS BEING VOTED UPON. THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE MADE, THE VOTE AND, WHERE APPLICABLE, THE ABSTENTION FROM VOTING AND PARTICIPATION, AND WHETHER A QUORUM WAS PRESENT. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE DETERMINATION OF THE CEO'S COMPENSATION IS IMPLEMENTED, REVIEWED, AND MONITORED BY THE BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE. THIS COMMITTEE IS COMPRISED OF FIVE INDEPENDENT BOARD MEMBERS AND IS ASSISTED BY AN OUTSIDE NATIONALLY RECOGNIZED CONSULTING FIRM DEALING WITH HOSPITAL EXECUTIVE COMPENSATION AND BENEFITS. SALARIES AND BENEFITS FOR THE CEO ARE EVALUATED BY THE EXECUTIVE COMPENSATION COMMITTEE ON AN ANNUAL BASIS AND COMPARED TO THE NATIONAL EXECUTIVE COMPENSATION BENCHMARKS FOR HOSPITAL EXECUTIVES AS PRESENTED BY THE OUTSIDE NATIONALLY RECOGNIZED CONSULTING FIRM SPECIALIZING IN EXECUTIVE COMPENSATION. THE DETERMINATION OF THE CFO'S, OTHER OFFICERS', AND KEY EMPLOYEES' COMPENSATION IS IMPLEMENTED, REVIEWED, AND MONITORED ON AN ANNUAL BASIS BY THE CEO, BASED ON NATIONAL EXECUTIVE COMPENSATION BENCHMARKS. |
| FORM 990, PART VI, SECTION C, LINE 19 | BDCH DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. BDCH DOES HOWEVER MAKE ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC USING SEVERAL METHODS. FIRST, AN ANNUAL REPORT IS DISTRIBUTED TO THE COMMUNITY USING THE CURRENT MAILING ADDRESSES IN OUR SERVICE AREA. IN ADDITION, SINCE WE HAVE TAX-EXEMPT BONDS, WE REPORT OUR FINANCIAL STATEMENTS THROUGH THE MUNICIPAL SECURITIES RULEMAKING BOARD (MSRB) - ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA). |
| FORM 990, PART IX, LINE 11G | OTHER FEES: PROGRAM SERVICE EXPENSES 5,491,360. MANAGEMENT AND GENERAL EXPENSES 3,159,059. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,650,419. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 1,505,433. MANAGEMENT AND GENERAL EXPENSES 329,013. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,834,446. |
| FORM 990, PART XI, LINE 9: | PENSION RELATED CHANGES -3,242,353. CHANGE IN BENEFICIAL INTEREST IN BDCH FOUNDATION 1,177,414. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| DODGE HEALTH ENTERPRISES LLC | |||||||||
| 715 SOUTH UNIVERSITY AVENUE | BEAVER DAM | WI | 53916 | 391538653 | REFERENCE LAB | WI | $893,426 | $6,176,256 | BDCH |
| DELMAN DEVELOPMENT LLC | |||||||||
| 707 SOUTH UNIVERSITY AVENUE | BEAVER DAM | WI | 53916 | 272375085 | REAL ESTATE | WI | $3,785 | $827,867 | BDCH |
| BEAVER DAM MEDICAL BUILDING 2 LLC | |||||||||
| 705 SOUTH UNIVERSITY AVENUE | BEAVER DAM | WI | 53916 | 391157876 | BUILDING MANAGEMENT | WI | $545,835 | $18,024,106 | BDCH |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BEAVER DAM HOSPITAL FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 707 SOUTH UNIVERSITY AVENUE | AddressLine1Txt |
| City | BEAVER DAM | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53916 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391499140 | EIN |
| Primary Activities | TO RAISE & DIRECT FUNDS FOR HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 9 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDCH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ACS BD DEVELOPMENT LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 707 SOUTH UNIVERSITY AVENUE | AddressLine1Txt |
| City | BEAVER DAM | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53916 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | REAL ESTATE | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDCH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | EXCLUDED | PredominantIncomeTypeTxt |
| Share Of EOY Assets | $113,760 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.99990 | OwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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