FURP.ORG / PUBLIC DATA EXPLORER

PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC (EIN 39-0910727)
Tax period
2014-10-01 to 2015-09-30
Filed
2016-08-03
IRS object ID
201632169349300403
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 ReturnHeader

FieldValueIRS element (for citing)
Return2016-08-03T06:31:44-05:00ReturnTs
Tax Period End2015-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN381357951PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 307AddressLine1Txt
CitySOUTHFIELDCityNm
State AbbreviationMIStateAbbreviationCd
ZIP480370307ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390910727EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WAUKESHA MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlWAUKBusinessNameControlTxt
Phone2629282496PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1725 AMERICAN AVENUEAddressLine1Txt
CityWAUKESHACityNm
State AbbreviationWIStateAbbreviationCd
ZIP53188ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRONALD FARRPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone2629282496PhoneNum
Signature2016-07-25SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID LOWENTHALPreparerPersonNm
PTINP00378651PTIN
Phone2483522500PhoneNum
Preparation2016-07-25PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-12-15 16:53:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSUSAN EDWARDSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1725 AMERICAN AVENUEAddressLine1Txt
CityWAUKESHACityNm
State AbbreviationWIStateAbbreviationCd
ZIP53188ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$448,882,974GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PROHEALTHCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1956FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionPROVIDER OF INPATIENT AND OUTPATIENT HOSPITAL SERVICES.ActivityOrMissionDesc
Voting Members Governing Body25VotingMembersGoverningBodyCnt
Voting Members Independent23VotingMembersIndependentCnt
Total Employee2751TotalEmployeeCnt
Total Volunteers430TotalVolunteersCnt
Total Gross UBI$2,794,379TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$1,405,552NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,591,390PYContributionsGrantsAmt
CY Contributions Grants$6,033,154CYContributionsGrantsAmt
PY Program Service Revenue$441,706,467PYProgramServiceRevenueAmt
CY Program Service Revenue$453,992,483CYProgramServiceRevenueAmt
PY Investment Income$33,906,585PYInvestmentIncomeAmt
CY Investment Income$2,938,438CYInvestmentIncomeAmt
PY Other Revenue$1,987,278PYOtherRevenueAmt
CY Other Revenue-$14,463,457CYOtherRevenueAmt
PY Total Revenue$479,191,720PYTotalRevenueAmt
CY Total Revenue$448,500,618CYTotalRevenueAmt
PY Grants And Similar Paid$17,933,881PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$14,355,604CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$135,938,150PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$140,805,351CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$276,341,058PYOtherExpensesAmt
CY Other Expenses$269,643,641CYOtherExpensesAmt
PY Total Expenses$430,213,089PYTotalExpensesAmt
CY Total Expenses$424,804,596CYTotalExpensesAmt
PY Revenues Less Expenses$48,978,631PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$23,696,022CYRevenuesLessExpensesAmt
Total Assets BOY$528,328,373TotalAssetsBOYAmt
Total Assets EOY$545,957,012TotalAssetsEOYAmt
Total Liabilities BOY$342,943,200TotalLiabilitiesBOYAmt
Total Liabilities EOY$443,452,554TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$185,385,173NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$102,504,458NetAssetsOrFundBalancesEOYAmt
MissionCONTINUOUSLY IMPROVING THE HEALTH OF OUR COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$404,709,925ExpenseAmt
Grant$14,355,604GrantAmt
Revenue$451,216,564RevenueAmt
DescWAUKESHA MEMORIAL HOSPITAL FULFILLS ITS EXEMPT PURPOSE BY PROVIDING CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. WAUKESHA MEMORIAL HOSPITAL ALSO USES ITS RESOURCES TO ADDRESS VARIOUS COMMUNITY NEEDS. WAUKESHA MEMORIAL HOSPITAL PROVIDED APPROXIMATELY 51,845 DAYS OF INPATIENT CARE AND APPROXIMATELY 298,400 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2015. SEE SCHEDULE H FOR ILLUSTRATION OF ITS PROGRAM SERVICE ACCOMPLISHMENTS.Desc
Total Program Service Expenses$404,709,925TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document266IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee2751EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members25GoverningBodyVotingMembersCnt
Independent Voting Member23IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or Procedure0WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonRONALD FARRPersonNm
Phone2629284740PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1N17 W24100 RIVERWOOD DRIVE SUITEAddressLine1Txt
CityWAUKESHACityNm
State AbbreviationWIStateAbbreviationCd
ZIP531881131ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (36 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
BETTY ARNDT
SECRETARY - PHC BOARD2.008.00Yes (X)Yes (X)$0$0$0
CHARLOTTE HALL
SECRETARY2.008.00Yes (X)Yes (X)$0$0$0
EDWARD J LUMP
TREASURER2.008.00Yes (X)Yes (X)$0$0$0
GARY BEYER MD
CHAIRPERSON2.008.00Yes (X)Yes (X)$0$0$0
HELEN FORSTER
VICE CHAIRPERSON - PART YEAR2.008.00Yes (X)Yes (X)$0$0$0
JANET SWANDBY
CHAIRPERSON - PART YEAR2.008.00Yes (X)Yes (X)$0$0$0
JIM GANNON
CHAIRPERSON - PHC BOARD2.008.00Yes (X)Yes (X)$0$0$0
JOHN ROBERTSTAD
PRESIDENT - PHC HOSPITAL DIVISION32.0016.00Yes (X)Yes (X)$2,580,701$0$87,072
JULIE SCHROEDER
TREASURER - PHC BOARD2.008.00Yes (X)Yes (X)$0$0$0
SUSAN EDWARDS
CEO - PHC2.0050.00Yes (X)Yes (X)$0$1,234,149$794,266
TED GARVEY
VICE CHAIRPERSON2.008.00Yes (X)Yes (X)$0$0$0
TOM PACKEE
SECRETARY - PHC BOARD - PART YEAR2.008.00Yes (X)Yes (X)$0$0$0
MARK MOHR
VICE CHAIR - PHC BOARD2.008.00Yes (X)Yes (X)$0$0$0
ARCH PEQUET
DIRECTOR2.008.00Yes (X)$0$0$0
CLIFF BROOKS
DIRECTOR2.008.00Yes (X)$0$0$0
DAVID ROELKE
DIRECTOR - PHC BOARD2.008.00Yes (X)$0$0$0
DOUG BRUINS
DIRECTOR2.008.00Yes (X)$0$0$0
DOUG HASTAD
DIRECTOR - PHC BOARD2.008.00Yes (X)$0$0$0
ELLEN MURPHY
DIRECTOR - PHC BOARD2.008.00Yes (X)$0$0$0
FRED GARCIA
DIRECTOR2.008.00Yes (X)$0$0$0
JANE HOPP
DIRECTOR2.008.00Yes (X)$0$0$0
JOHN HALLET
DIRECTOR2.008.00Yes (X)$0$0$0
JOHN RAASCH
DIRECTOR - PHC BOARD2.008.00Yes (X)$0$0$0
MIKE ERWIN
DIRECTOR - PHC BOARD2.008.00Yes (X)$0$0$0
PAUL BOSTROM
DIRECTOR2.008.00Yes (X)$0$0$0
RALPH RAMIREZ
DIRECTOR - PHC BOARD2.008.00Yes (X)$0$0$0
SANDRA STEARNS
DIRECTOR2.008.00Yes (X)$0$0$0
TIM WESTLAKE
DIRECTOR2.008.00Yes (X)$0$0$0
RONALD FARR
CFO2.0050.00Yes (X)$0$537,662$44,943
JAMES GARDNER
VP MEDICAL AFFAIRS40.000.00$505,657$0$69,915Yes (X)
KENNETH PRICE
CHIEF ADMIN OFFICER2.0050.00$0$385,639$88,805Yes (X)
CHRISTOPHER WILLIAMS
PRESIDENT-PHC HOSPITAL DIVISION40.000.00$269,866$0$27,134Yes (X)
ERIC HENDEE
CHIEF PHYSICIST - RADIOLOGY40.000.00$204,840$0$44,898Yes (X)
JOHN MAY
VP - AMBULATORY40.000.00$327,385$0$33,398Yes (X)
MICHAEL KOWALOK
PHYSICIST40.000.00$178,495$0$19,195Yes (X)
VERNA SEITZ
PRESIDENT-PHC HOSPITAL DIVISION40.000.00$277,779$0$12,771Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,344,723TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,157,450TotReportableCompRltdOrgAmt
Total Other Compensation$1,222,397TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K73IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
GILBANE BUILDING CO
5301-99TH AVEKENOSHAWI53144CONSTRUCTION SERVICES$27,337,897
MORTENSON CONSTRUCTION
17975 WEST SARAH LANEBROOKFIELDWI53045CONSTRUCTION SERVICES$6,707,359
FINDORFF INC
PO BOX 575MADISONWI53701CONSTRUCTION SERVICES$4,569,033
MEDICAL COLLEGE OF WI
PO BOX 13308MILWAUKEEWI53213PROVIDER SERVICES$3,627,318
PERFICIENT INC
PO BOX 200026PITTSBURGHPA15251CONSULTING SERVICES$2,345,847
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K77CntrctRcvdGreaterThan100KCnt
Related Organizations$5,850,678RelatedOrganizationsAmt
All Other Contributions$182,476AllOtherContributionsAmt
Total Contributions$6,033,154TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT REV.622110$439,411,846$439,411,846
MEDICAL SERVICE LAB621500$8,688,634$5,912,715$2,775,919
HOSPITAL JOINT VENTURE622310$2,478,992$2,478,992
ORTHO SURGERY CENTER621400$1,348,259$1,348,259
SURGERY CENTER621400$1,238,922$1,238,922

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$825,830TotalRevenueColumnAmt
Related Or Exempt Func Income$825,830RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$453,992,483TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,952,991TotalRevenueColumnAmt
Exclusion$2,952,991ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Personal$75,871PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Personal$43,192PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Personal$32,679PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$32,679TotalRevenueColumnAmt
Unrelated Business Revenue$18,460UnrelatedBusinessRevenueAmt
Exclusion$14,219ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$324,611OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$339,164OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$14,553OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$14,553TotalRevenueColumnAmt
Exclusion-$14,553ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA722210$1,925,613$1,925,613
GIFT SHOP453220$36,238$36,238
LEGAL LOSS ON BOND DEFEASANCE523920-$16,457,987-$16,457,987
FieldValueIRS element (for citing)
Other Revenue Total-$14,496,136OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$448,500,618TotalRevenueColumnAmt
Related Or Exempt Func Income$451,216,564RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$2,794,379UnrelatedBusinessRevenueAmt
Exclusion-$11,543,479ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$14,355,604TotalAmt
Program Services$14,355,604ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,121,129TotalAmt
Management And General$1,121,129ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$103,666,838TotalAmt
Program Services$99,078,737ProgramServicesAmt
Management And General$4,588,101ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$8,236,727TotalAmt
Program Services$7,787,960ProgramServicesAmt
Management And General$448,767ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$20,516,820TotalAmt
Program Services$14,807,590ProgramServicesAmt
Management And General$5,709,230ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$7,263,837TotalAmt
Program Services$7,113,579ProgramServicesAmt
Management And General$150,258ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$112,775,811TotalAmt
Program Services$106,194,870ProgramServicesAmt
Management And General$6,580,941ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$14,078,980TotalAmt
Program Services$14,065,803ProgramServicesAmt
Management And General$13,177ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$5,505,161TotalAmt
Program Services$5,074,272ProgramServicesAmt
Management And General$430,889ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$10,427,373TotalAmt
Program Services$10,427,373ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$41,460,116TotalAmt
Program Services$41,460,116ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL SUPPLIES$34,591,887$34,591,887
DRUGS & PHARMACEUTICALS$26,687,615$26,687,615
MEDICAID PROVIDER TAXES$13,097,493$13,097,493
BAD DEBTS$6,342,455$6,342,455

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$4,676,750TotalAmt
Program Services$3,624,571ProgramServicesAmt
Management And General$1,052,179ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$424,804,596TotalAmt
Program Services$404,709,925ProgramServicesAmt
Management And General$20,094,671ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$894,111BOYAmt
EOY$822,860EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$18,156,414BOYAmt
EOY$8,375,189EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$53,274,339BOYAmt
EOY$52,165,325EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$7,577,164BOYAmt
EOY$6,879,955EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$6,189,834BOYAmt
EOY$6,729,249EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$889,913,590LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$481,931,348LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$316,982,222BOYAmt
EOY$407,982,242EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$28,326,631BOYAmt
EOY$26,683,494EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$9,662,324BOYAmt
EOY$11,738,120EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$87,265,334BOYAmt
EOY$24,580,578EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$528,328,373BOYAmt
EOY$545,957,012EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$68,714,984BOYAmt
EOY$82,542,336EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$2,500EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$188,849,190BOYAmt
EOY$23,480,562EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$32,856,868BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$52,522,158BOYAmt
EOY$337,427,156EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$342,943,200BOYAmt
EOY$443,452,554EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$184,716,962BOYAmt
EOY$101,629,025EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$668,211BOYAmt
EOY$875,433EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$185,385,173BOYAmt
EOY$102,504,458EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$528,328,373BOYAmt
EOY$545,957,012EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$23,696,022ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,417,090NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$105,159,647OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$0BeginningYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,710,388BeginningYearBalanceAmt
Other Expenditures$6,710,388OtherExpendituresAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,625,195BeginningYearBalanceAmt
Contributions$88,002ContributionsAmt
Investment Earnings Or Losses-$2,809InvestmentEarningsOrLossesAmt
End Year Balance$6,710,388EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,542,035BeginningYearBalanceAmt
Contributions$84,926ContributionsAmt
Investment Earnings Or Losses-$1,766InvestmentEarningsOrLossesAmt
End Year Balance$6,625,195EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,729,263OtherCostOrOtherBasisAmt
Book Value$22,729,263BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$451,814,662OtherCostOrOtherBasisAmt
Depreciation$176,880,664DepreciationAmt
Book Value$274,933,998BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,711,381OtherCostOrOtherBasisAmt
Depreciation$2,580,433DepreciationAmt
Book Value$130,948BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$398,350,635OtherCostOrOtherBasisAmt
Depreciation$302,470,251DepreciationAmt
Book Value$95,880,384BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,307,649OtherCostOrOtherBasisAmt
Book Value$14,307,649BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$407,982,242TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
ACCRUED POSTRETIREMENT MEDICAL$104,440
FAIR VALUE-INTEREST RATE SWAP$21,957,856
ASSET RETIREMENT OBLIGATION$99,763
ACCUMULATED MIN PENSION LIABILITY$40,903,757
INTERCOMPANY NOTES PAYABLE$273,933,438
OTHER LONG TERM LIABILITY$427,902
FieldValueIRS element (for citing)
Total Liability$337,427,156TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationFIN48 DISCLOSURE: PHC, WMH, OMH, NATIONAL REGENCY, PHMG, PHCF, AND PHHC 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 PURSUANT TO SECTION 501(A) OF THE CODE. ALL OF THESE ENTITIES ARE, HOWEVER, SUBJECT TO FEDERAL AND STATE INCOME TAXES ON ANY UNRELATED BUSINESS INCOME UNDER THE PROVISIONS OF SECTION 511 OF THE CODE. WHS IS A FOR-PROFIT CORPORATION THAT ACCOUNTS FOR INCOME TAXES UNDER THE ASSET AND LIABILITY METHOD OF ACCOUNTING. A CURRENT TAX LIABILITY OR ASSET IS RECOGNIZED FOR THE ESTIMATED TAXES PAYABLE OR REFUNDABLE ON TAX RETURNS FOR THE YEAR. DEFERRED TAX LIABILITIES OR ASSETS ARE RECOGNIZED FOR THE ESTIMATED FUTURE TAX EFFECTS OF TEMPORARY DIFFERENCES BETWEEN FINANCIAL REPORTING AND TAX ACCOUNTING. PHS IS TREATED AS A PARTNERSHIP FOR INCOME TAX PURPOSES. INCOME AND LOSSES OF PHS ARE PASSED TO ITS MEMBERS. PHS INCOME PASSED THROUGH TO PHC IS NOT CONSIDERED TAXABLE TO PHC UNLESS IT IS CONSIDERED UNRELATED BUSINESS INCOME. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY IF THE CORPORATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CORPORATION AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2015, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2012.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically Indigent0FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,707,228TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,707,228NetCommunityBenefitExpnsAmt
Total Expense0.00410TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$44,894,973TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$18,749,799DirectOffsettingRevenueAmt
Net Community Benefit Expns$26,145,174NetCommunityBenefitExpnsAmt
Total Expense0.06250TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$46,602,201TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$18,749,799DirectOffsettingRevenueAmt
Net Community Benefit Expns$27,852,402NetCommunityBenefitExpnsAmt
Total Expense0.06660TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs29ActivitiesOrProgramsCnt
Persons Served41847PersonsServedCnt
Total Community Benefit Expns$4,441,324TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,960DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,438,364NetCommunityBenefitExpnsAmt
Total Expense0.01060TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs8ActivitiesOrProgramsCnt
Persons Served3073PersonsServedCnt
Total Community Benefit Expns$6,008,469TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,723,880DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,284,589NetCommunityBenefitExpnsAmt
Total Expense0.00550TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$1,069,265TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,286,402DirectOffsettingRevenueAmt
Net Community Benefit Expns-$1,217,137NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs8ActivitiesOrProgramsCnt
Persons Served21824PersonsServedCnt
Total Community Benefit Expns$1,139,879TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,139,879NetCommunityBenefitExpnsAmt
Total Expense0.00270TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs46ActivitiesOrProgramsCnt
Persons Served66744PersonsServedCnt
Total Community Benefit Expns$12,658,937TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,013,242DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,645,695NetCommunityBenefitExpnsAmt
Total Expense0.01880TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs46ActivitiesOrProgramsCnt
Persons Served66744PersonsServedCnt
Total Community Benefit Expns$59,261,138TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$24,763,041DirectOffsettingRevenueAmt
Net Community Benefit Expns$34,498,097NetCommunityBenefitExpnsAmt
Total Expense0.08540TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served271PersonsServedCnt
Total Community Benefit Expns$20,372TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$20,372NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Persons Served33PersonsServedCnt
Total Community Benefit Expns$72,590TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$72,590NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$11,352TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$11,352NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$335TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$335NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served1619PersonsServedCnt
Total Community Benefit Expns$17,439TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$17,439NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served10PersonsServedCnt
Total Community Benefit Expns$56,418TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$56,418NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs11ActivitiesOrProgramsCnt
Persons Served1933PersonsServedCnt
Total Community Benefit Expns$178,506TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$178,506NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$6,381,316BadDebtExpenseAmt
Bad Debt Expense Attributable$596,985BadDebtExpenseAttributableAmt
Reimbursed By Medicare$83,914,339ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$146,072,426CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$62,158,087MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)

Primary ActivitiesPrimaryActivitiesTxtOrg Profit Or OwnershipOrgProfitOrOwnershipPctPhysicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 PROHEALTH ALIGNED LLC
AMBULATORY SURGERY CENTER0.510000.49000
2 THE ORTHOPEDIC SURGERY CENTER LLC
ORTHOPEDIC SURGICAL SERVICES0.490000.49000
FieldValueIRS element (for citing)
Hospital Facilities2HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndTeaching HospitalTeachingHospitalIndEmergency Room OtherEmergencyRoomOtherIndOtherOtherDesc
WAUKESHA MEMORIAL HOSPITAL INC
1725 AMERICAN AVENUEWAUKESHAWI53188WWW.PROHEALTHCARE.ORG#41Yes (X)Yes (X)Yes (X)Yes (X)
REHABILITATION HOSPITAL OF WISCONSIN LLC
21625 COLDWATER CREEK DRIVEWAUKESHAWI53188Yes (X)INPATIENT REHABILITATION

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNumFirst Licensed CY Or PYFirstLicensedCYOrPYIndTax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYIndCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndExisting ResourcesExistingResourcesIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndOther Health IssuesOtherHealthIssuesIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndOtherOtherIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Conducted With Non FcltsCHNAConductedWithNonFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndOwn Website URLOwnWebsiteURLTxtPaper Copy Public InspectionPaperCopyPublicInspectionIndRpt Available Thru Other MethodRptAvailableThruOtherMethodIndImplementation Strategy AdoptImplementationStrategyAdoptIndImplementation Strategy AdptImplementationStrategyAdptYrStrategy Posted WebsiteStrategyPostedWebsiteIndStrategy Website URLStrategyWebsiteURLTxtStrategy AttachedStrategyAttachedIndOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctFPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePctIncome Level CriteriaIncomeLevelCriteriaIndAsset Level CriteriaAssetLevelCriteriaIndMedical Indigency CriteriaMedicalIndigencyCriteriaIndInsurance Status CriteriaInsuranceStatusCriteriaIndUnderinsurance Stat CriteriaUnderinsuranceStatCriteriaIndResidency CriteriaResidencyCriteriaIndOther CriteriaOtherCriteriaIndExplained BasisExplainedBasisIndApp Financial Asst ExplnAppFinancialAsstExplnIndDescribed InfoDescribedInfoIndDescribed Suprt DocDescribedSuprtDocIndProvided Hospital ContactProvidedHospitalContactIndProvided Nonprofit ContactProvidedNonprofitContactIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndFAP Available On WebsiteFAPAvailableOnWebsiteIndFAP Available On Website URLFAPAvailableOnWebsiteURLTxtFAP App Available On WebsiteFAPAppAvailableOnWebsiteIndFAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxtFAP Summary On WebsiteFAPSummaryOnWebsiteIndFAP Summary On Website URLFAPSummaryOnWebsiteURLTxtFAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeIndFAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgIndFAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgIndFAP Notice DisplayedFAPNoticeDisplayedIndCommuntity Notified FAPCommuntityNotifiedFAPIndOther PublicityOtherPublicityIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndPermit No ActionsPermitNoActionsIndCollection ActivitiesCollectionActivitiesIndFAP Notified Upon AdmissionFAPNotifiedUponAdmissionIndFAP Notified Before DischargeFAPNotifiedBeforeDischargeIndFAP Notified All PatientsFAPNotifiedAllPatientsIndDocumented Elig DeterminationDocumentedEligDeterminationIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndAverage Negotiated RatesAverageNegotiatedRatesIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesIndOther Method UsedOtherMethodUsedInd
WAUKESHA MEMORIAL HOSPITAL INC
100Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)13Yes (1)Yes (1)0Yes (1)Yes (X)FULL WEBSITE LISTED IN PART V SECTION CYes (X)Yes (X)Yes (1)13Yes (1)SEE PART V, SECTION B, LINE 7D DISCLOSURE00Yes (1)Yes (X)200.000000000000400.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)WWW.PROHEALTHCARE.ORG/PATIENT-GUEST-SERVICES-BILLING-AND-INSURANCE.ASPXYes (X)WWW.PROHEALTHCARE.ORG/PATIENT-GUEST-SERVICES-BILLING-AND-INSURANCE.ASPXYes (X)WWW.PROHEALTHCARE.ORG/PATIENT-GUEST-SERVICES-BILLING-AND-INSURANCE.ASPXYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
REHABILITATION HOSPITAL OF WISCONSIN LLC
20000Yes (1)Yes (X)150.000000000000250.000000000000Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (1)00Yes (X)

Supplemental Information SupplementalInformationGrp (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 3J: THE CHNA RESULTS CAME FROM A 400 PERSON CONSUMER TELEPHONE SURVEY CONDUCTED BY THE UW CENTER FOR URBAN POPULATION HEALTH AT THE REQUEST OF PROHEALTH CARE AND OTHER MILWAUKEE COLLABORATIVE PARTNERS IN ADDITION TO 51 INTERVIEWS ENCOMPASSING A RANGE OF PROVIDERS, POLICY-MAKERS AND OTHER LOCAL EXPERTS. 38 OF THESE INTERVIEWS WERE CONDUCTED AS PART OF THE MILWAUKEE COLLABORATIVE WHILE 13 INTERVIEWS WERE CONDUCTED BY PROHEALTH CARE STAFF ALONE. SECONDARY DATA WAS COLLECTED FROM A WIDE RANGE OF PUBLICLY AVAILABLE SITES AND ORGANIZATIONS INCLUDING STATE AND FEDERAL RESOURCES. HEAVY UTILIZATION OF DATA WAS FROM MEDICARE CHRONIC DISEASE DASHBOARD, CENTER FOR DISEASE CONTROL, WISCONSIN DEPARTMENT OF HEALTH AND HUMAN SERVICES, INCLUDING WISCONSIN BEHAVIORAL RISK FACTOR SURVEY, 2014 AND WISCONSIN EPIDEMIOLOGICAL PROFILE ON ALCOHOL AND OTHER DRUG USE, WAUKESHA COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, AMONG SEVERAL OTHERS. THIS HELPED IDENTIFY ADDED DEMOGRAPHICS SUCH AS POPULATIONS WITH ANY DISABILITY, WISCONSIN LEADING CAUSES OF DEATH, HOMELESSNESS AND SPECIFIC LIFESTYLE RISK FACTORS.
WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 5: SEE PART V, SECTION B, LINE 3J DISCLOSURE
WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 6A: OCONOMOWOC MEMORIAL HOSPITAL AND REHABILITATION HOSPITAL OF WISCONSIN LLC
WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 7D: THE CHNA, WHICH INCLUDES THE IMPLEMENTATION STRATEGY, IS AVAILABLE AT WWW.PROHEALTHCARE.ORG/ABOUT-US-COMMUNITY-BENEFIT.ASPX AND TO COMMUNITY MEMBERS UPON REQUEST.
WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 11: THE FACILITY CONTINUES TO FOCUS ITS COMMUNITY OUTREACH PROGRAMS ON THE PRIORITY NEEDS DETERMINED FROM THE LAST CHNA. THE ENTITY FEELS ALL NEEDS ARE BEING ADDRESSED EITHER THROUGH DIRECT OUTREACH OR ENSURING OTHER COMMUNITY LEADERS ARE AWARE OF SIMILAR NEEDS AND THOSE PATIENTS OR USERS ARE PROVIDED WITH THOSE COMMUNITY RESOURCES IF NOT OFFERED BY THE FACILITY.
WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 13B: THE HOSPITAL PROVIDES CHARITY CARE OR REDUCED COST CARE FOR A VARIETY OF PATIENTS IN NEED. SOME OF THESE PATIENTS IN NEED MAY TECHNICALLY HAVE INCOME IN EXCESS OF MINIMUM FEDERAL POVERTY GUIDELINES. FOR ADDITIONAL DETAILS ON THE CRITERIA USED BY THE HOSPITAL FACILITY TO DETERMINE ELIGIBILITY, PLEASE REFER TO THE FINANCIAL ASSISTANCE POLICY AVAILABLE ON THE HOSPITAL'S WEBSITE AT: WWW.PROHEALTHCARE.ORG/PATIENT-GUEST-SERVICES-BILLING-AND-INSURANCE.ASPX
REHABILITATION HOSPITAL OF WISCONSIN LLCPART V, SECTION B, LINE 13B: THE HOSPITAL PROVIDES CHARITY CARE OR REDUCED COST CARE FOR A VARIETY OF PATIENTS IN NEED. SOME OF THESE PATIENTS IN NEED MAY TECHNICALLY HAVE INCOME IN EXCESS OF MINIMUM FEDERAL POVERTY GUIDELINES. FOR ADDITIONAL DETAILS ON THE CRITERIA USED BY THE HOSPITAL FACILITY TO DETERMINE ELIGIBILITY, PLEASE REFER TO THE FINANCIAL ASSISTANCE POLICY AVAILABLE ON THE HOSPITAL'S WEBSITE AT: WWW.PROHEALTHCARE.ORG/PATIENT-GUEST-SERVICES-BILLING-AND-INSURANCE.ASPX
WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 13H: "THE FACILITY ALSO CONSIDERS THE FOLLOWING IN THE FINANCIAL ASSISTANCE POLICY: SIZE OF THE PATIENT'S FAMILY WILL BE DETERMINED BY THE NUMBER OF DEPENDENTS CLAIMED ON THE APPLICANT'S TAX RETURNS OR IDENTIFIED AS PART OF THE HOUSEHOLD, HOUSEHOLD INCOME WILL INCLUDE ALL INCOME FROM ANY SOURCE INCLUDING WAGES AND SALARIES AND OTHER SOURCES OF INCOME INCLUDING, BUT NOT LIMITED TO, THE FOLLOWING:-ALL PENSIONS FROM STATE, FEDERAL OR PRIVATE SOURCES-INCOME FROM ANNUITIES, IRAS, TSAS, 401(K)S-STOCKS, OR BONDS-VETERANS BENEFITS-SOCIAL SECURITY PAYMENTS-REGULARLY RECEIVED INSURANCE CHECKS SUCH AS UNEMPLOYMENT BENEFITS AND WORKMAN'S COMPENSATION-ALIMONY/CHILD SUPPORT-RETURNS ON INVESTMENTS/NET RENTS AND NET PROFITS FROM BUSINESS
WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 16I: REFERENCE TO THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON THE BACK ALL PATIENT STATEMENTS. ALSO THROUGH CUSTOMER RELATIONS VERBAL REMINDER OF THE FINANCIAL ASSISTANCE POLICY ARE PROVIDED WHEN DISCUSSING OPEN BALANCES.
REHABILITATION HOSPITAL OF WISCONSIN LLCPART V, SECTION B, LINE 16I: NOTIFIED PATIENTS OF FINANCIAL ASSISTANCE POLICY AND OFFERED APPLICATION IF PATIENT OR FAMILY MEMBER EXPRESSED FINANCIAL HARDSHIP.
REHABILITATION HOSPITAL OF WISCONSIN LLCPART V, SECTION B, LINE 22D: THE HOSPITAL HAS NEVER HAD AN EMERGENCY CARE SITUATION REQUIRING THE DETERMINATION OF AN AMOUNT TO BE BILLED FOR SERVICES TO A PATIENT IN THESE CIRCUMSTANCES. IF SUCH A CASE ARISES, THE HOSPITAL WILL CONSULT WITH WAUKESHA MEMORIAL HOSPITAL TO DETERMINE APPROPRIATE EMERGENCY CARE CHARGES AND THEN APPLY PROCEDURES ACCORDING TO CHARITY CARE AND PRIVATE PAY DISCOUNT POLICIES IF THE PATIENT IS ELIGIBLE.
PART V, SECTION B, LINE 16FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
WAUKESHA MEMORIAL HOSPITAL, INC PART V, SECTION B, LINE 16A WEBSITE:WWW.PROHEALTHCARE.ORG/PATIENT-GUEST-SERVICES-BILLING-AND-INSURANCE.ASPX
WAUKESHA MEMORIAL HOSPITAL, INC PART V, SECTION B, LINE 16B WEBSITE:WWW.PROHEALTHCARE.ORG/PATIENT-GUEST-SERVICES-BILLING-AND-INSURANCE.ASPX
WAUKESHA MEMORIAL HOSPITAL, INC PART V, SECTION B, LINE 16C WEBSITE:WWW.PROHEALTHCARE.ORG/PATIENT-GUEST-SERVICES-BILLING-AND-INSURANCE.ASPX
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
REHAB HOSPITAL OF WI OUTPATIENT CLINIC
1625 COLDWATER CREEK DRIVEWAUKESHAWI53188OUTPATIENT REHABILATION CLINIC
PROHEALTH ALIGNED LLC
1111 DELAFIELD ST SUITE 100WAUKESHAWI53188AMBULATORY SURGERY CENTER
THE ORTHOPEDIC SURGERY CENTER LLC
W238 N 1610 BUSSE ROAD SUITE 100WAUKESHAWI53188ORTHOPEDIC SURGERY CENTER

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:N/A
PART I, LINE 6A:PROHEALTH CARE, INC. (EIN 39-1486873)
PART I, LINE 7:THE COST-TO-CHARGE RATIO WAS USED TO CALCULATE AMOUNTS ON LINES 7A-7D. THIS WAS CALCULATED BY USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE HOSPITAL'S FINANCIAL COST REPORTING SYSTEM WAS USED TO CALCULATE THE AMOUNTS ON LINES 7E-7I
PART I, LINE 7G:N/A
PART I, LN 7 COL(F):$6,342,455 OF BAD DEBT EXPENSES FROM WAUKESHA MEMORIAL HOSPITAL, INC. WAS INCLUDED ON FORM 990, PART, IX, LINE 25. ADDITIONALLY, THERE WAS BAD DEBT EXPENSE OF $38,861 RELATED TO REHABILITATION HOSPITAL OF WISCONSIN, LLC. BOTH AMOUNTS WERE SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE.
PART II, COMMUNITY BUILDING ACTIVITIES:WAUKESHA MEMORIAL HOSPITAL HAS FOSTERED A WIDE VARIETY OF PARTNERSHIPS WITH NUMEROUS AGENCIES AND INITIATIVES THAT BENEFIT OUR ENTIRE COMMUNITY BEYOND THOSE THAT ARE DIRECTLY ASSOCIATED WITH HEALTH. OUR EFFORTS TO HELP BUILD A SAFE AND VIBRANT COMMUNITY ARE IN SOME WAYS, JUST AS IMPORTANT AS OUR TREMENDOUS EFFORTS TO IMPROVE COMMUNITY HEALTH. WE BELIEVE COMMUNITY BUILDING IS ABOUT NEIGHBORHOODS AND ONE EXAMPLE OF THAT IS OUR SUPPORT OF LOCAL NEIGHBORHOOD GROUPS THAT ADDRESS SAFETY, PROPERTY APPEARANCE AND CONNECTIVITY OF RESIDENTS. WE PROVIDE FUNDING FOR BEAUTIFICATION AND THE CLEANUP OF COMMON PROPERTIES AND STREETS, AS WELL AS THE LAND, EXPERTISE AND RESOURCES FOR COMMUNITY RAIN AND CROP GARDENS. AS PART OF OUR LEADERSHIP VOLUNTEERISM PROGRAM, WE PROVIDE ASSISTANCE AT LOCAL LIBRARIES AND LITERACY PROGRAMS, AND HAVE A STRONG PRESENCE FOR NEIGHBORHOOD SAFETY INITIATIVES. INVOLVEMENT WITH YOUTH IS A YEAR-ROUND FOCUS AS WE ASSEMBLE AND DISTRIBUTE BACK-PACKS TO LOW INCOME CHILDREN, MAKING SURE THEIR SCHOOL YEAR GETS OFF TO A GOOD START AND WE VOLUNTEER AT LOCAL HIGH SCHOOLS FOR HEALTH CAREER AWARENESS AND "SAFE PROM/GRADUATION" EVENTS. WE ARE THE MAJOR SPONSOR OF "LEADERSHIP WAUKESHA", A PROGRAM THAT FOCUSES ON THE DEVELOPMENT OF EMERGING LEADERS IN OUR COUNTY. WE SUPPORT HOMELESS SHELTERS, ARE ACTIVE MEMBERS OF THE HOUSING ACTION COALITION/CONTINUUM OF CARE AND THE COUNTY'S HISPANIC COLLABORATIVE NETWORK. WE ARE TREMENDOUSLY PROUD OF OUR WORK WITH EASTER SEALS AND THE WISCONSIN DEPARTMENT OF WORKFORCE DEVELOPMENT, SERVING AS WAUKESHA COUNTY'S ONLY SITE FOR PROJECT SEARCH, A WORKFORCE TRAINING PROGRAM FOR DEVELOPMENTALLY/PHYSICALLY DISABLED INDIVIDUALS.
PART III, LINE 4:BAD DEBT EXPENSE FOOTNOTE FOR WAUKESHA MEMORIAL HOSPITAL, INC: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ARE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. THE BAD DEBT COST WAS REVIEWED BY THE HOSPITAL'S REVENUE CYCLE TEAM AND THE AMOUNT OF BAD DEBT ESTIMATED TO BE ATTRIBUTABLE TO PATIENTS WHO WOULD HAVE QUALIFIED UNDER OUR FINANCIAL ASSISTANCE PROGRAM IS 30% OF TOTAL BAD DEBTS.THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON PART III LINE 2 IS THE BAD DEBT EXPENSE REPORTED ON FORM 990 PART IX FOR WAUKESHA MEMORIAL HOSPITAL PLUS ITS SHARE OF THE BAD DEBT EXPENSE OF REHABILITATION HOSPITAL OF WISCONSIN LLC.BAD DEBT EXPENSE FOOTNOTE FOR REHABILITATION HOSPITAL OF WISCONSIN LLC:ACCOUNTS RECEIVABLE PRIMARILY CONSIST OF AMOUNTS DUE FROM THIRD-PARTY PAYORS AND PATIENTS. THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING RECEIVABLES IS CRITICAL TO ITS RESULTS OF OPERATIONS AND CASH FLOWS. TO PROVIDE FOR ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE, THE HOSPITAL ESTABLISHES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THE PRIMARY UNCERTAINTY OF SUCH ALLOWANCES LIES WITH UNINSURED PATIENT RECEIVABLES AND DEDUCTIBLES, CO-PAYMENTS OR OTHER AMOUNTS DUE FROM INDIVIDUAL PATIENTS. THE HOSPITAL'S POLICY TO RECORD AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON A PERCENTAGE OF NET RECEIVABLES BY AGE OF BALANCE AFTER DISCHARGE DATE.THE HOSPITAL HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS THAT RELIES ON A NUMBER OF ANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NO SINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THE HOSPITAL UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASH COLLECTION EXPERIENCE, REVENUE TRENDS BY PAYOR CLASSIFICATION AND REVENUE DAYS IN ACCOUNTS RECEIVABLE. INDIVIDUAL PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE HOSPITAL'S POLICIES.BAD DEBT EXPENSE IS RECORDED FOR FINANCIAL STATEMENT PURPOSES BASED ON UNCOLLECTED REVENUE, BUT THE RELATED COST COULD BE DETERMINED BY APPLYING COST TO CHARGE RATIOS FROM THE MEDICARE COST REPORT. DISCOUNTS ARE RECORDED TO AN APPROPRIATE CONTRA REVENUE ACCOUNT INCLUDING CHARITY CARE WHEN APPLICABLE; PAYMENTS RECEIVED AFTER AN ACCOUNT HAS BEEN WRITTEN OFF WOULD DECREASE BAD DEBT EXPENSE. MOST OF THE PATIENTS FOR WHICH BAD DEBT EXPENSE IS RECORDED WOULD PROBABLY QUALIFY FOR SOME LEVEL OF FINANCIAL ASSISTANCE ACCORDING TO HOSPITAL POLICIES, BUT MANY CHOOSE NOT TO COMPLETE THE NECESSARY FINANCIAL ASSISTANCE APPLICATION SO THAT THIS CAN BE PROPERLY DETERMINED.
PART III, LINE 8:THE SHORTFALL ON LINE 7 SHOULD NOT BE TREATED AS COMMUNITY BENEFIT. COSTING METHODOLOGY USED IS THE COST TO CHARGE RATIO AS REPORTED ON THE MEDICARE COST REPORT.
PART III, LINE 9B:PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE WILL HAVE A CHARITY DISCOUNT APPLIED TO THEIR BALANCES AT THE TIME OF BILLING. IF THIS RESULTS IN NO BALANCE DUE FORM THE PATIENT, THEN THE PATIENT WILL NOT RECEIVE A STATEMENT. IF A BALANCE REMAINS AFTER THE DISCOUNT PERCENTAGE IS APPLIED, THE PATIENT WILL RECEIVE A STATEMENT FOR THE BALANCE DUE. THE STATEMENT CYCLE IS CONSISTENT FOR ALL PATIENTS.
PART VI, LINE 2:COMMUNITY NEEDS ARE IDENTIFIED BASED UPON A REVIEW OF STATE, COUNTY AND COMMUNITY HEALTH DATA AND ASSESSMENTS. THIS INCLUDES SUCH DOCUMENTS AS: THE STATE HEALTH PLAN, THE COUNTY HEALTH REPORT CARD, THE WAUKESHA COMMUNITY HEALTH SURVEY, THE HEALTHY PEOPLE 2020 PLAN AND VARIOUS OTHER NEEDS ASSESSMENTS, SUCH AS THE UNITED WAY/UNIVERSITY OF WISCONSIN SURVEY OF WAUKESHA COUNTY. ADDITIONALLY, WE HAVE ACTIVELY PARTNERED WITH OUR COUNTY HEALTH DEPARTMENT IN THEIR COMMUNITY HEALTH IMPROVEMENT PLAN AND PROCESS (CHIPP) ASSESSMENT. TO COMPLEMENT ALL OF THESE DATA SOURCES, WE ALSO PERIODICALLY PERFORM A SERVICE GAP ANALYSIS WITH OUR EMPLOYED COMMUNITY OUTREACH NURSES AS WELL AS LOCAL NON-PROFIT AGENCIES WITH WHICH WE PARTNER. WE THEN ANALYZE THE DATA, IDENTIFY THE PRESSING NEEDS, AND PROACTIVELY PLAN AND IMPLEMENT COMMUNITY BENEFIT INITIATIVES TO ADDRESS THESE NEEDS. WE ARE CURRENTLY FINALIZING IMPLEMENTATION PLANS FOR PRIORITIES IDENTIFIED IN OUR 2016 NEEDS ASSESSMENT. DATA COLLECTION AND ANALYSIS FOR THIS ROUND BEGAN IN SPRING 2015.
PART VI, LINE 3:EVERY PATIENT WITH A SELF PAY BALANCE RECEIVES A STATEMENT WHICH CONVEYS THE AVAILABILITY OF COMMUNITY (CHARITY) CARE AND A CONTACT NUMBER FOR FURTHER INFORMATION. PATIENTS THAT ARE UNINSURED RECEIVE AN UNINSURED DISCOUNT WHICH IS LISTED ON THE FIRST STATEMENT THAT THEY RECEIVE. PATIENTS RECEIVE A TOTAL OF FOUR STATEMENTS. EACH STATEMENT CONTAINS VERBIAGE REFERENCING THE HOSPITAL'S COMMUNITY CARE PROGRAM AND A CONTACT NUMBER FOR FURTHER INFORMATION. IF SOMEONE HAS BEEN FOUND ELIGIBLE FOR SOME LEVEL OF CHARITY CARE, THE ELIGIBILITY PERIOD IS THREE MONTHS SO ANY SUBSEQUENT ACCOUNTS DURING THAT TIMEFRAME WOULD BE DISCOUNTED AT WHATEVER LEVEL OF CHARITY CARE THE PATIENT IS DEEMED ELIGIBLE. PATIENTS MAY REAPPLY FOR COMMUNITY CARE WHEN THEIR ELIGIBILITY PERIOD HAS EXPIRED. SELF PAY PATIENTS MAY ALSO BE INFORMED OF THE HOSPITAL'S COMMUNITY CARE PROGRAM WHILE THEY ARE INPATIENTS. SOCIAL WORK AND/OR THE BUSINESS OFFICE MAY MAKE CONTACT WITH THESE PATIENTS DURING THEIR STAY TO INFORM THEM OF THE COMMUNITY CARE PROGRAM AND ASSIST THEM WITH COMPLETION OF THE APPLICATION.INFORMATION IS AVAILABLE AT REGISTRATION AREAS RELATED TO OUR COMMUNITY CARE PROGRAM. THIS INFORMATION CONTAINS CONTACT INFORMATION FOR THE HOSPITAL'S CENTRAL BUSINESS OFFICE WHERE PATIENTS CAN RECEIVE ASSISTANCE IN OBTAINING AND COMPLETING APPLICATIONS.
PART VI, LINE 4:PROHEALTH CARE SERVES ABOUT 285,000 PEOPLE EACH YEAR IN WAUKESHA COUNTY AND PORTIONS OF SURROUNDING COUNTIES. IN EVERY FEDERAL POPULATION CENSUS, WAUKESHA COUNTY HAS RECORDED AN INCREASE IN POPULATION. SINCE 1950, THE POPULATION GREW FROM 85,901 TO OVER 390,000. WAUKESHA COUNTY HAS AN AGING POPULATION WITH 15.9% OVER THE AGE OF 65 AND A MEDIAN AGE OF 43.1 YEARS WHICH FAR SURPASSES STATE AVERAGES AND IS THE HIGHEST MEDIAN AGE OF PEER COUNTIES. THE RATE OF RETIREMENT IS LIKELY TO SURPASS THE RATE OF ENTRY INTO THE WORKFORCE BETWEEN 2015 AND 2020. THE RACIAL MAKEUP OF THE WAUKESHA COUNTY COMMUNITY IS AS FOLLOWS: WHITE 93.9%, HISPANIC OR LATINO 4.5%, ASIAN 3.1%, BLACK 1.4%. MEDIAN HOUSEHOLD INCOME IS $75850, WITH 5.8% OF PEOPLE LIVING BELOW THE POVERTY LEVEL. THE LARGEST POCKET OF THOSE LIVING IN POVERTY IS IN THE URBAN ENVIRONMENT OF THE CITY OF WAUKESHA WITH A RATE OF 11.70%. UNEMPLOYMENT IN WAUKESHA COUNTY STOOD AT 3.1% IN OCTOBER, 2015. WAUKESHA COUNTY IS LARGE (580 SQUARE MILES) AND DIVERSE, INCLUDING URBAN, SUBURBAN AND RURAL AREAS. THE PRESENCE OF SOME HIGH INCOME COMMUNITIES IN WAUKESHA COUNTY OFTEN GIVES A MISTAKEN IMPRESSION OF OVERALL WEALTH. OFTEN OVERLOOKED IS A GROWING POPULATION OF LOW INCOME, NON-ENGLISH SPEAKING, VULNERABLE AND MARGINALIZED CITIZENS WHO FACE ENORMOUS ODDS IN ACCESSING HEALTH CARE. THE WAUKESHA COUNTY MEDICAID POPULATION HAS NEARLY TRIPLED IN 10 YEARS, AND NOW REPRESENTS 8.33% OF THE POPULATION. BETWEEN 2000 AND 2010, THE LATINO/A POPULATION IN WAUKESHA COUNTY GREW BY 6,620 RESIDENTS. DOWNTOWN WAUKESHA WAS DECLARED A "MEDICALLY UNDERSERVED" AREA AND A "HEALTH-PROFESSIONAL SHORTAGE AREA" BY THE FEDERAL GOVERNMENT IN 2008. AS AN UNDERSERVED AREA, MEDICAL OPTIONS FOR INDIVIDUALS, PARTICULARLY THOSE WITHOUT HEALTH INSURANCE OR WITH PUBLIC INSURANCE, ARE SEVERELY LIMITED BECAUSE PRIVATE SERVICE PROVIDERS OFTEN REFUSE TO CARE FOR THESE INDIVIDUALS. CONSEQUENTLY, PROHEALTH CARE EMBARKED ON A FUND-RAISING INITIATIVE TO SUPPORT THE FORMATION OF AN FEDERALLY QUALIFIED HEALTH CENTER (FQHC) IN DOWNTOWN WAUKESHA. THAT HEALTH CENTER OPENED IN LATE 2012 AND IS FINANCIALLY SUPPORTED BY PROHEALTH CARE.
PART VI, LINE 5:WAUKESHA MEMORIAL HOSPITAL IS GOVERNED BY A COMMUNITY BOARD. WE ARE PROUD OF THE NUMEROUS AND STRONG PARTNERSHIPS WE HAVE FORMED WITH A WIDE VARIETY OF NOT-FOR-PROFIT HEALTH AND HUMAN SERVICES AGENCIES AS WE WORK TOGETHER TO FORGE A STRONGER, HEALTHIER COMMUNITY. WE ARE ACTIVELY INVOLVED WITH PROGRAMMING, BOARD OVERSIGHT AND ONGOING FINANCIAL SUPPORT OF THE WAUKESHA COMMUNITY HEALTH CENTER, THE ONLY FEDERALLY-QUALIFIED HEALTH CENTER IN OUR AREA. WE ALSO PROVIDE FINANCIAL SUPPORT AS WELL AS IN-KIND SUPPORT TO TWO FREE CLINICS SERVING OUR AREA. WE WERE INSTRUMENTAL IN FORMING SEVERAL KEY AGENCIES DESIGNED TO MEET AN URGENT COMMUNITY NEED. FOR EXAMPLE, THROUGH OUR LEADERSHIP AND SUPPORT, THE WAUKESHA COUNTY COMMUNITY DENTAL CLINIC WAS FORMED AND WE HAVE PROVIDED ONGOING FINANCIAL SUPPORT AND PROVIDED CLINICAL AND OFFICE SPACE SO THIS AGENCY CAN CARRY OUT ITS MISSION. THE SAME IS TRUE FOR SAFE BABIES HEALTHY FAMILIES (PROVIDING SERVICES FOR AT RISK PREGNANT WOMEN AND THEIR CHILDREN) AND STILLWATERS CANCER SUPPORT SERVICES. WE PROVIDE SPACE AND CLINICAL EXPERTISE TO THE LOCAL 'MEALS ON WHEELS' PROGRAM, SERVING AT-RISK ELDERLY AND DISABLED INDIVIDUALS. SEVERAL OF OUR STAFF ARE ACTIVELY INVOLVED WITH THE HEALTH DEPARTMENT'S CHIPP AND SERVE ON A VARIETY OF COMMITTEES FOR THE AREA'S DEPARTMENT OF HEALTH AND HUMAN SERVICES. WE HOST COMMUNITY-WIDE HEALTH FAIRS OFFERING A WIDE VARIETY OF FREE SCREENINGS AND OFFER AN ONGOING AND IMPRESSIVE MENU OF FREE COMMUNITY EDUCATION CLASSES (INCLUDING EVIDENCE-BASED SELF-HELP WORKSHOPS). PROHEALTH CARE REACHES OUT INTO OUR COMMUNITY TO MEET THE NEEDS OF ITS RESIDENTS. FROM THE ALZHEIMER'S ASSOCIATION TO WAUKESHA DRUG FREE COMMUNITIES, AND DOZENS OF AGENCIES IN BETWEEN, PROHEALTH CARE IS THERE, PROVIDING VOLUNTEERS, FINANCIAL SUPPORT AND PARTNERSHIPS THAT HELP TO IMPROVE THE HEALTH OF OUR COMMUNITY.
PART VI, LINE 6:OUR HOSPITAL IS A MEMBER OF THE PROHEALTH CARE HEALTH SYSTEM WHICH SERVES AS OUR PARENT COMPANY. WHILE COMMUNITY BENEFIT RESPONSIBILITIES RESIDE WITH OUR HOSPITAL BOARD, THE PARENT COMPANY PLAYS A KEY ROLE IN COORDINATING COMMUNITY NEEDS ASSESSMENTS, COMMUNITY BENEFIT PROGRAM PLANNING, AND EVALUATION.A DESCRIPTION OF EACH AFFILIATES ROLE IN PROMOTING HEALTH WITHIN THE COMMUNITIES SERVED IS AS FOLLOWS:PROHEALTH CARE, INC. - HELPS TO MANAGE THE HOSPITALS TO ENSURE THEY CAN PROMOTE HEALTH AND WELLNESS WITHIN THE COMMUNITY.NATIONAL REGENCY OF NEW BERLIN, INC. - OWNS AND OPERATES SENIOR LIVING CENTERS AS A MEANS TO PROMOTE HEALTH WITHIN THE COMMUNITY.PROHEALTH HOME CARE, INC. - PROVIDES HOSPICE AND HOME HEALTH CARE SERVICES AS A MEANS TO PROMOTE HEALTH WITHIN THE COMMUNITY.PROHEALTH CARE FOUNDATION, INC. - SUPPORTS THE CHARITABLE MISSION OF WAUKESHA MEMORIAL HOSPITAL AND OCONOMOWOC MEMORIAL HOSPITAL SO THAT IT MAY PROVIDE HEALTH SERVICES WITHIN THE COMMUNITY.PROHEALTH CARE MEDICAL ASSOCIATES, INC. - PHCMA OPERATES VARIOUS CLINIC AND URGENT CARE LOCATIONS THROUGHOUT WAUKESHA COUNTY AND THE SURROUNDING COMMUNITIES. PHCMA FULFILLS ITS EXEMPT PURPOSE BY PROVIDING CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. PHCMA PROVIDED 446,622 CLINIC VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2015.OCONOMOWOC MEMORIAL HOSPITAL, INC. - PROVIDES CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. OCONOMOWOC MEMORIAL HOSPITAL ALSO USES ITS RESOURCES TO ADDRESS VARIOUS COMMUNITY NEEDS. OCONOMOWOC MEMORIAL HOSPITAL PROVIDED APPROXIMATELY 8,816 DAYS OF INPATIENT CARE AND APPROXIMATELY 70,446 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2015.
PART VI, LINE 7, REPORTS FILED WITH STATESWI

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1PROHEALTH CARE INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1N17 W24100 RIVERWOOD DR STE 200AddressLine1Txt
CityWAUKESHACityNm
State AbbreviationWIStateAbbreviationCd
ZIP531881131ZIPCd
FieldValueIRS element (for citing)
Recipient EIN391486873RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Non Cash Assistance$14,355,604NonCashAssistanceAmt
Valuation Method UsedN/AValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc
Purpose Of GrantTO ASSIST PROHEALTH CARE, INC. IN ITS CHARITABLE MISSION.PurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationALL GRANTS ARE APPROVED AND PROCESSED BY THE ORGANIZATION'S MANAGEMENT.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JOHN ROBERTSTAD
PRESIDENT - PHC HOSPITAL DIVISION$461,644$0$227,084$0$1,891,973$0$54,862$0$32,210$0$2,667,773$0$1,891,973$0
SUSAN EDWARDS
CEO - PHC$0$803,007$0$431,142$0$0$0$774,636$0$19,630$0$2,028,415$0$0
RONALD FARR
CFO$0$400,473$0$137,189$0$0$0$20,607$0$24,336$0$582,605$0$0
JAMES GARDNER
VP MEDICAL AFFAIRS$357,758$0$147,899$0$0$0$38,877$0$31,038$0$575,572$0$0$0
KENNETH PRICE
CHIEF ADMIN OFFICER$0$269,157$0$116,482$0$0$0$64,204$0$24,601$0$474,444$0$0
CHRISTOPHER WILLIAMS
PRESIDENT-PHC HOSPITAL DIVISION$194,362$0$75,504$0$0$0$5,447$0$21,687$0$297,000$0$0$0
ERIC HENDEE
CHIEF PHYSICIST - RADIOLOGY$198,032$0$6,808$0$0$0$18,081$0$26,817$0$249,738$0$0$0
JOHN MAY
VP - AMBULATORY$240,116$0$87,269$0$0$0$11,500$0$21,898$0$360,783$0$0$0
MICHAEL KOWALOK
PHYSICIST$177,610$0$885$0$0$0$8,750$0$10,445$0$197,690$0$0$0
VERNA SEITZ
PRESIDENT-PHC HOSPITAL DIVISION$201,088$0$76,691$0$0$0$9,601$0$3,170$0$290,550$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THIS ENTITY RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR OFFICERS AND DIRECTORS: 1. COMPENSATION COMMITTEE 2. COMPENSATION STUDY 3. APPROVAL OF THE BOARD ANNUALLY APPROVING COMPENSATION AMOUNTS 4. INDEPENDENT COMPENSATION CONSULTANT
PART I, LINE 4BLINE 4B: NAME CURRENT FISCAL YEAR PAYOUT -JOHN ROBERTSTAD $1,891,973 PROHEALTH CARE INC. (PHC) MAINTAINS TWO SUPPLEMENTAL RETIREMENT PLANS (SERPS) FOR A SELECT GROUP OF EXECUTIVES OF PHC AND ITS AFFILIATED ENTITIES. THESE SERPS ARE UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION PLANS THAT ARE INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THESE SERPS ARE TAXABLE TO THE PARTICIPATING EXECUTIVES WHEN SUCH AMOUNTS ARE VESTED.
PART I, LINE 6PRO HEALTH CARE HAS A LEADERSHIP INCENTIVE PROGRAM FOR LEADERS OF THE CORPORATION AND RELATED ORGANIZATIONS (COLLECTIVELY THE "SYSTEM"). THE PLAN RELATES FINANCIAL REWARD TO THE SYSTEM'S ACHIEVEMENT OF CERTAIN FINANCIAL AND NON-FINANCIAL OBJECTIVES. THE PRIMARY PURPOSE OF THE PLAN IS TO SUPPORT THE SYSTEM'S MISSION TO ACHIEVE CONTINUED GROWTH AND DEMONSTRATE VALUE THROUGH: (1) A SEAMLESS CONTINUUM OF PATIENT CENTERED CARE; (2) NATIONALLY RECOGNIZED OUTCOMES; (3) RESPONSIBLE AND EFFICIENT USE OF HEALTH CARE RESOURCES; AND (4) A FOCUS ON THE HEALTH OF OUR COMMUNITY.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1WISCONSIN HEALTH & EDUCATIONAL FACILITIESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN391337855BondIssuerEIN
CUSIP97710BB50CUSIPNum
Bond Issued2011-02-16BondIssuedDt
Issue Price$32,039,358IssuePriceAmt
PurposeCURRENT REFUND BONDS ISSUED 11/14/95 & CURRENT REFUND BONDS ISSUED 5/13/99.PurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$8,558,796RetiredAmt
Total Proceeds$32,039,358TotalProceedsAmt
Issuance Costs From Proceeds$597,186IssuanceCostsFromProceedsAmt
Other Spent Proceeds$31,442,173OtherSpentProceedsAmt
Substantial Completion2001SubstantialCompletionYr
Current RefundingYes (1)CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropYes (1)MgmtContractBondFincdPropInd
Engage Bond Counsel ContractsYes (1)EngageBondCounselContractsInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, A - COL. CTHE CUSIP # OF 97710BB50 ON FORM 8038 WAS NOT THE NUMBER ON THE BOND OF THE LATEST MATURITY. THE NUMBER FOR THE LATEST MATURITY IS CORRECTLY REPORTED ON SCHEDULE K.
PART I, A - COL. ETHE TOTAL ISSUE PRICE ON FORM 8038 IS $35,678,572.65. THE AMOUNT REPORTED ON SCHEDULE K IS ONLY THE AMOUNT OF THE ISSUE BENEFITING THE REPORTING ORGANIZATION.
PART II, A - LINE 3SALE PROCEEDS OF ISSUE IN AMOUNT OF $32,039,358 PLUS ZERO INVESTMENT PROCEEDS.
PART II, A - LINE 6PROCEEDS IN THE AMOUNT OF $31,442,172.63 ALLOCABLE TO REPORTING ORGANIZATION DEPOSITED IN REFUNDING ESCROWS ON 2/16/11; BALANCE ON 9/30/14 IS ZERO.
PART II, A - LINE 13YEAR OF SUBSTANTIAL COMPLETION OF PROJECTS FINANCED WITH REFUNDED PRIOR BONDS ISSUED 11/14/95 WAS 1995 AND YEAR OF SUBSTANTIAL COMPLETION OF PROJECTS FINANCED WITH REFUNDED PRIOR BONDS ISSUED 5/13/99 WAS 2001.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6PROHEALTH CARE, INC. IS THE SOLE CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7BPROHEALTH CARE, INC. HOLDS CERTAIN RESERVED POWERS OVER THE (NON-STOCK) CORPORATION, INCLUDING APPROVAL OF STRATEGIC PLANNING, ANNUAL OPERATING AND CAPITAL BUDGETS, BORROWING, TRANSFER, LEASE, PLEDGE OR SALE OF ASSETS.
FORM 990, PART VI, SECTION B, LINE 11AFTER THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S TAX PREPARERS AND PRIOR TO FILING THE FORM 990, SELECT EXECUTIVE MEMBERS OF THE ORGANIZATION AND THE AUDIT & COMPLIANCE COMMITTEE PERFORMED A REVIEW. THEN THE ORGANIZATION'S TAX PREPARERS MADE A PRESENTATION TO THE AUDIT COMMITTEE, AND THE BOARD OF DIRECTORS WAS PROVIDED A COPY OF THE RETURN, WHICH WAS SUBSEQUENTLY FILED BY THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 12CALL OFFICERS, VICE-PRESIDENTS, MANAGERS AND ABOVE, AS WELL AS BOARD MEMBERS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. ALL REPORTED POTENTIAL CONFLICTS OF INTEREST ARE TRACKED IN THE CORPORATE COMPLIANCE DEPARTMENT. THEY ARE REVIEWED AND ANY PERSON IDENTIFIED AS HAVING A POTENTIAL CONFLICT OF INTEREST IS GIVEN DIRECTION AS TO WHAT STEPS SHOULD BE TAKEN TO MITIGATE THE CONCERN. ALL EMPLOYEES ARE EDUCATED ANNUALLY. THE STEPS TAKEN WHEN A CONFLICT ARISES ARE AS FOLLOWS: FOR THE BOARD OF DIRECTORS, THE RESTRICTION IS NOT BEING ALLOWED TO PARTICIPATE IN DISCUSSION OR VOTING RELATED TO ANY DECISION WHERE THE BOARD MEMBER HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST. FOR LEADERS, RESEARCHERS, AND EMPLOYEES, RECOMMENDATIONS ARE MADE FROM COMPLIANCE MANAGER TO LEADERSHIP AND/OR HUMAN RESOURCES. RESTRICTIONS CAN RANGE FROM ANY OF THE FOLLOWING: DISCLOSING POTENTIAL CONFLICTS OF INTEREST TO PATIENTS; NOT BEING ABLE TO BE INVOLVED IN DISCUSSION OR DECISION MAKING ON SPECIFIC TOPICS; AND NOT BEING ABLE TO WORK AT PROHEALTH IN THE SPECIFIC ROLE WHERE THE REPORTED CONFLICT EXISTS. IF THE RECOMMENDATION IS CHALLENGED, THE MATTER GOES TO THE SENIOR EXECUTIVE TEAM FOR A DECISION.
FORM 990, PART VI, SECTION B, LINE 15AN INDEPENDENT, EXTERNAL COMPENSATION REVIEW IS CONDUCTED FOR THE POSITIONS OF CEO/PRESIDENT, EXECUTIVE DIRECTOR, VICE-PRESIDENT, SENIOR VICE-PRESIDENT AND ABOVE. THE RESULTS OF THE COMPENSATION REVIEW ARE PRESENTED TO THE BOARD'S EXECUTIVE COMMITTEE FOR APPROVAL. ANY MEMBER OF THE EXECUTIVE COMMITTEE WHOSE SALARY IS INCLUDED IN THE SALARY REVIEW IS RECUSED FROM THE APPROVAL PROCESS FOR HIS/HER SALARY APPROVAL. THIS PROCESS WAS LAST DONE IN 2015.
FORM 990, PART VI, SECTION C, LINE 19FINANCIAL STATEMENTS, GOVERNING DOCUMENTS & CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 16B:THE PROCESS IS TO HAVE ALL JOINT VENTURE ARRANGEMENTS REVIEWED BY THE LEGAL DEPARTMENT TO ENSURE IT MEETS ALL LEGAL REQUIREMENTS AND TO ENSURE THAT WAUKESHA MEMORIAL HOSPITAL, INC. MAY RETAIN ITS EXEMPT STATUS.
FORM 990, PART IX, LINE 11GPHYSICIAN FEES: PROGRAM SERVICE EXPENSES 6,257,407. MANAGEMENT AND GENERAL EXPENSES 143,478. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,400,885. PHMG PHYSICIAN SUBSIDY: PROGRAM SERVICE EXPENSES 7,106,797. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,106,797. LINEN SERVICES: PROGRAM SERVICE EXPENSES 1,172,664. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,172,664. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 7,060,488. MANAGEMENT AND GENERAL EXPENSES 1,061,676. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,122,164. PHC SERVICES: PROGRAM SERVICE EXPENSES 73,397,217. MANAGEMENT AND GENERAL EXPENSES 5,375,787. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 78,773,004. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 11,200,297. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,200,297.
FORM 990, PART XI, LINE 9:CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS -3,655,709. CHANGE IN MINIMUM PENSION LIABILITY -9,085,213. INVESTMENT CONSIDERATION -56,120,714. 2014 DEBT SERIES PROCEEDS -62,000,000. EQUITY TRANSFER FROM RELATED ORGANIZATIONS 9,543,000. OTHER CHANGES 158,989. TRANSFER FROM PHC-PARENT 16,000,000.
FORM 990, PART XII, LINE 2CTHE AUDIT PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
OCONOMOWOC MEMORIAL HOSPITAL INC
791 SUMMIT AVENUEOCONOMOWOCWI53066390794174HOSPITALWI501(C)(3)LINE 3PROHEALTH CARE INCYes (1)
PROHEALTH CARE FOUNDATION INC
725 AMERICAN AVENUEWAUKESHAWI53188391314542CHARITABLE SUPPORTWI501(C)(3)LINE 7PROHEALTH CARE INCYes (1)
PROHEALTH HOME CARE INC
N17 W24100 RIVERWOOD DR SUITE 200WAUKESHAWI53188200067392HEALTHCAREWI501(C)(3)LINE 3PROHEALTH CARE INCYes (1)
NATIONAL REGENCY OF NEW BERLIN INC
N17 W24100 RIVERWOOD DR SUITE 200WAUKESHAWI53188391077992HEALTHCAREWI501(C)(3)LINE 9PROHEALTH CARE INCYes (1)
PROHEALTH CARE INC
N17 W24100 RIVERWOOD DR SUITE 200WAUKESHAWI53188391786873MANAGEMENTWI501(C)(3)LINE 11C, III-FI0N/A
PROHEALTH CARE MEDICAL ASSOCIATES INC
N17 W24100 RIVERWOOD DR SUITE 200WAUKESHAWI53188391083015HEALTHCAREWI501(C)(3)LINE 3PROHEALTH CARE INCYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPctDirect Controlling NADirectControllingNACd
PROHEALTH ALIGNED LLC (DBA MSC)
1111 DELAFIELD STREET STE 100WAUKESHAWI53188263324572SURGERY CENTERWIWAUKESHA MEMORIAL HOSPITAL INCRELATED$1,426,627$2,732,4180Yes (1)0.51000
REHABILITATION HOSPITAL OF WISCONSIN LLC
1625 COLDWATER CREEK DRIVEWAUKESHAWI53188262332250INPATIENT REHABILITATIONWIWAUKESHA MEMORIAL HOSPITAL INCRELATED$7,662,527$3,112,7210Yes (1)0.49000
THE ORTHOPEDIC SURGERY CENTER LLC
W238 N1610 BUSSE ROADWAUKESHAWI53188208356016ORTHOPEDIC SURGICAL SERVICESWIWAUKESHA MEMORIAL HOSPITAL INCRELATED$924,244$2,496,2830Yes (1)0.30000
PROHEALTH SOLUTIONS LLC
2000 PEWAUKEE RD SUITE CWAUKESHAWI53188273863494ACCOUNTABLE CARE ORGANIZATIONWIN/A
LAKE COUNTRY ENDOSCOPY CENTER
1185 CORPORATE CENTER DROCONOMOWOCWI53066261572986ENDOSCOPY SERVICESWIN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
WAUKESHA HEALTH SYSTEM INC
N17 W24100 RIVERWOOD DRIVE SUITE 20WAUKESHAWI53188391507910HEALTHCAREWIN/AC0
EMPATHIA PACIFIC INC
31416 AGOURA RD STE 180WESTLAKE VILLAGECA91361953070501HEALTHCARECAN/AC0
NATIONAL AVENUE DEVELOPMENT CORPORATION
N17 W24100 RIVERWOOD DRIVE SUITE 20WAUKESHAWI53188391417226HEALTHCAREWIN/AC0
EMPATHIA INC
N17 W24100 RIVERWOOD DRIVE SUITE 20WAUKESHAWI53188391567366HEALTHCAREWIN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (28 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
PROHEALTH CARE MEDICAL ASSOCIATES INC
A$1,174,407ACTUAL AMOUNT RECEIVED
REHABILITATION HOSPITAL OF WISCONSIN LLC
A$1,200,679ACTUAL AMOUNT RECEIVED
PROHEALTH CARE INC
B$14,355,604ACTUAL AMOUNT INCURRED
PROHEALTH CARE FOUNDATION INC
C$5,850,678ACTUAL AMOUNT RECEIVED
WAUKESHA HEALTH SYSTEM INC
K$72,513ACTUAL AMOUNT INCURRED
PROHEALTH CARE MEDICAL ASSOCIATES INC
K$536,435ACTUAL AMOUNT INCURRED
NATIONAL REGENCY OF NEW BERLIN INC
K$577,686ACTUAL AMOUNT INCURRED
REHABILITATION HOSPITAL OF WISCONSIN LLC
L$125,120ACTUAL AMOUNT RECEIVED
PROHEALTH CARE INC
M$78,773,003ACTUAL AMOUNT INCURRED
WAUKESHA HEALTH SYSTEM INC
M$294,913ACTUAL AMOUNT INCURRED
PROHEALTH ALIGNED LLC (DBA MSC)
M$85,779ACTUAL AMOUNT INCURRED
PROHEALTH SOLUTIONS LLC
M$484,211ACTUAL AMOUNT INCURRED
WAUKESHA HEALTH SYSTEM INC
P$207,009ACTUAL AMOUNT INCURRED
PROHEALTH CARE MEDICAL ASSOCIATES INC
P$7,507,454ACTUAL AMOUNT INCURRED
PROHEALTH SOLUTIONS LLC
P$176,500ACTUAL AMOUNT INCURRED
OCONOMOWOC MEMORIAL HOSPITAL INC
Q$8,704,632ACTUAL AMOUNT RECEIVED
WAUKESHA HEALTH SYSTEM INC
Q$393,467ACTUAL AMOUNT RECEIVED
PROHEALTH CARE MEDICAL ASSOCIATES INC
Q$9,408,168ACTUAL AMOUNT RECEIVED
PROHEALTH HOME CARE INC
Q$830,440ACTUAL AMOUNT RECEIVED
EMPATHIA INC
Q$1,190,639ACTUAL AMOUNT RECEIVED
PROHEALTH CARE INC
R$110,137,714ACTUAL AMOUNT INCURRED
THE ORTHOPEDIC SURGERY CENTER LLC
R$6,000,000ACTUAL AMOUNT INCURRED
PROHEALTH SOLUTIONS LLC
S$704,000ACTUAL AMOUNT RECEIVED
REHABILITATION HOSPITAL OF WISCONSIN LLC
S$903,915ACTUAL AMOUNT RECEIVED
OCONOMOWOC MEMORIAL HOSPITAL INC
S$1,560,000ACTUAL AMOUNT RECEIVED
PROHEALTH CARE INC
S$16,000,000ACTUAL AMOUNT RECEIVED
PROHEALTH ALIGNED LLC (DBA MSC)
S$1,363,444ACTUAL AMOUNT RECEIVED
THE ORTHOPEDIC SURGERY CENTER LLC
S$1,199,513ACTUAL AMOUNT RECEIVED