BALDWIN AREA MEDICAL CENTER INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- BALDWIN AREA MEDICAL CENTER INC (EIN 39-0808526)
- Tax period
- 2014-10-01 to 2015-09-30
- Filed
- 2016-08-09
- IRS object ID
- 201632229349301263
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-08-09T12:55:34-05:00 | ReturnTs |
| Tax Period End | 2015-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3703 OAKWOOD HILLS PKWY | AddressLine1Txt |
| City | EAU CLAIRE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390808526 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BALDWIN AREA MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BALD | BusinessNameControlTxt |
| Phone | 7156843311 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 730 10TH AVENUE | AddressLine1Txt |
| City | BALDWIN | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 540020300 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRIAN LOVDAHL | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 7156843311 | PhoneNum |
| Signature | 2016-08-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PAUL M TRACZEK CPA | PreparerPersonNm |
| PTIN | P00449155 | PTIN |
| Phone | 7158323407 | PhoneNum |
| Preparation | 2016-08-05 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ALISON PAGE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 730 10TH AVENUE | AddressLine1Txt |
| City | BALDWIN | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 540020300 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $38,152,047 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HEALTHYBALDWIN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1936 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | BALDWIN AREA MEDICAL CENTER, INC., IS A NONSTOCK, NONPROFIT CORPORATION OPERATING A CRITICAL ACCESS HOSPITAL AS A MEANS TO PROVIDE PATIENT ACCESS TO COMPREHENSIVE MEDICAL, SURGICAL, CLINICAL, AND EMERGENCY CARE FOR INPATIENT AND AMBULATORY PATIENT POPULATIONS. THE CORNERSTONE OF THE MEDICAL CENTER'S MISSION IS TO PROVIDE PATIENTS FROM THE COMMUNITIES WE SERVE WITH ACCESS TO COORDINATED, INTEGRATED, HIGH QUALITY HEALTHCARE VIA A SEAMLESS CONTINUUM OF CARE THROUGH THE SERVICES OF THE HOSPITAL AND CLINICS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 340 | TotalEmployeeCnt |
| Total Volunteers | 52 | TotalVolunteersCnt |
| Total Gross UBI | $2,704 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $131,898 | PYContributionsGrantsAmt |
| CY Contributions Grants | $608,690 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $33,606,312 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $36,494,587 | CYProgramServiceRevenueAmt |
| PY Investment Income | $139,723 | PYInvestmentIncomeAmt |
| CY Investment Income | $172,505 | CYInvestmentIncomeAmt |
| PY Other Revenue | $98,649 | PYOtherRevenueAmt |
| CY Other Revenue | $89,058 | CYOtherRevenueAmt |
| PY Total Revenue | $33,976,582 | PYTotalRevenueAmt |
| CY Total Revenue | $37,364,840 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,500 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $500 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,890,192 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $20,173,350 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $91,450 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $91,450 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $14,541,624 | PYOtherExpensesAmt |
| CY Other Expenses | $15,434,987 | CYOtherExpensesAmt |
| PY Total Expenses | $33,433,316 | PYTotalExpensesAmt |
| CY Total Expenses | $35,700,287 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $543,266 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,664,553 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $32,314,516 | TotalAssetsBOYAmt |
| Total Assets EOY | $39,967,016 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,528,403 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,465,621 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $23,786,113 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $25,501,395 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | BALDWIN AREA MEDICAL CENTER, INC. IS DEDICATED TO DELIVERING HIGH QUALITY HEALTH AND WELLNESS SERVICES AND BEING A HEALTHCARE RESOURCE FOR EVERYONE WE SERVE. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $24,531,201 | ExpenseAmt |
| Grant | $500 | GrantAmt |
| Revenue | $28,454,803 | RevenueAmt |
| Desc | BALDWIN AREA MEDICAL CENTER, INC. (THE "MEDICAL CENTER") OPERATES A CRITICAL ACCESS HOSPITAL WITH A CLEAR AND CONSISTENT CHARITABLE PURPOSE WHICH IS TO PROVIDE HEALTHCARE SERVICES TO ALL RESIDENTS OF THE COMMUNITIES SERVED WITHOUT REGARD TO AGE, RACE, GENDER, CREED, NATIONAL ORIGIN, ABILITY TO PAY, AND PHYSICAL OR MENTAL HANDICAP. THE DEDICATION OF THE MEDICAL CENTER'S WORKFORCE PROVIDES A STRONG FOUNDATION FOR PROGRAM DEVELOPMENT THAT IS BASED UPON COMMUNITY NEED AND IN ALIGNMENT WITH ORGANIZATIONAL VALUES OF EXCELLENCE, INTEGRITY, SERVICE, TEAMWORK, AND STEWARDSHIP. THE MEDICAL CENTER OFFERS COMPREHENSIVE PRIMARY CARE SERVICES AND MANY OTHER SERVICES DEVELOPED IN RESPONSE TO THE NEEDS OF THE PATIENT POPULATION WE SERVE. THE MEDICAL CENTER IS DEVELOPING A FOCUS ON INTEGRATIVE HEALTH SERVICES THAT INCLUDE HOLISTIC SERVICES PROVIDED BY TRADITIONAL MEDICAL PRACTITIONERS, BEHAVIORAL HEALTH SPECIALISTS, DIETICIANS, AND FITNESS EXPERTS. THE MEDICAL CENTER IS DEVELOPING SPECIFIC SERVICES IN THE AREA OF RESILIENCY TRAINING (I.E., A COLLECTION OF SERVICES AIMED AT TEACHING PEOPLE TO MANAGE THEIR OWN PHYSICAL AND EMOTIONAL WELL-BEING) AND IS PILOTING RESILIENCY SERVICES WITH EMPLOYEES. DURING FISCAL YEAR 2015, THERE WERE 374 MEDICAL/SURGICAL ADMISSIONS, 208 SWING BED DAYS, AND 52 NEWBORN DELIVERIES. THE MEDICAL CENTER ALSO HAD 4,154 EMERGENCY ROOM VISITS IN FISCAL YEAR 2015 ALONG WITH ALMOST 30,000 AMBULATORY VISITS. MEDICAL CENTER REPRESENTATIVES PROVIDE A VARIETY OF VOLUNTEER SERVICES TO ENHANCE THE COMMUNITY BY PARTICIPATING IN THE RELAY FOR LIFE, LOCAL HIGH SCHOOL EDUCATION PROGRAMS FOR STUDENTS IN REGARD TO CAREER CHOICES, AND MANY OTHER INITIATIVES. THE MEDICAL CENTER OFFERS SCHOLARSHIP FUNDS TO SELECT AREA HIGH SCHOOL SENIORS LOOKING TO PURSUE A CAREER IN HEALTHCARE AND GRANT PROGRAM DOLLARS TO EMPLOYEES LOOKING TO ENHANCE THEIR PROFESSIONAL SKILLS IN A HEALTH RELATED EDUCATION FIELD. THE MEDICAL CENTER FURTHER SERVES THE COMMUNITY BY PROVIDING OUTREACH PROGRAMS AND SERVICES THAT ARE INTENDED TO ENHANCE THE HEALTH AND WELL-BEING OF THE PEOPLE IN THE COMMUNITY. SOME OF THESE SERVICES AND/OR SUPPORT GROUPS INCLUDE: COMMUNITY WIDE HEALTH AND WELLNESS PROGRAMS; "BE WELL" ? A PROGRAM TO PREVENT OBESITY IN ELEMENTARY AGE STUDENTS; CARDIAC, DIABETES, MENTAL HEALTH, AND DEPRESSION SUPPORT GROUPS; DIABETES SELF-MANAGEMENT CLASSES; NUTRITION AND WEIGHT MANAGEMENT CONSULTATION AND PROGRAMS; EXPECTANT PARENT CLASSES AND BREASTFEEDING EDUCATION. THE MEDICAL CENTER IS ALSO OFFERING VIRTUAL EDUCATION CLASSES WHERE MEDICAL CENTER REPRESENTATIVES PROVIDE EDUCATIONAL EVENTS VIA WEBINAR SESSIONS.UNCOMPENSATED CARE:THE MOST SIGNIFICANT EXPRESSION OF CHARITABLE SERVICE IS THE PROVISION OF UNCOMPENSATED HEALTHCARE SERVICES.A. CHARITY CARE THE MEDICAL CENTER PROVIDES HEALTHCARE SERVICES TO ALL PEOPLE, REGARDLESS OF THEIR ABILITY TO PAY. FOR THOSE INDIVIDUALS WITH VERIFIED INCOME THAT IS AT OR BELOW 100% OF THE FEDERAL POVERTY GUIDELINES, SERVICES ARE PROVIDED WITHOUT ANY EXPECTATION OF PAYMENT. FOR INDIVIDUALS THAT HAVE VERIFIED INCOME AT OR BELOW 300% OF THE FEDERAL POVERTY GUIDELINE, CARE IS AVAILABLE ON A DISCOUNTED SLIDING SCALE. THE MEDICAL CENTER SCREENS POTENTIAL CHARITY CARE PROGRAM PARTICIPANTS AND MAKES PATIENT INFORMATION READILY AVAILABLE ON THE CHARITY CARE PROGRAM. PROCEDURES ARE IN PLACE THAT ACTIVELY SEEK TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR CHARITY CARE. SEE ADDITIONAL INFORMATION ON THE COST OF THIS COMMUNITY BENEFIT IN SCHEDULE H OF THE FORM 990.B. PROVISION FOR BAD DEBT - UNCOLLECTABLE ACCOUNTS THE MEDICAL CENTER ESTABLISHED A PROVISION FOR BAD DEBT EXPENSE (VALUED AT THE USUAL AND CUSTOMARY CHARGE) THAT REPRESENTS THOSE HEALTHCARE SERVICES WHICH WERE PROVIDED TO PATIENTS THAT WERE UNABLE OR UNWILLING TO PAY. SEE ADDITIONAL INFORMATION ON THE COST OF THIS COMMUNITY BENEFIT IN SCHEDULE H OF THE FORM 990. C. GOVERNMENT ENTITLEMENT PROGRAMS THE MEDICAL CENTER FURNISHES HEALTHCARE SERVICES TO PERSONS COVERED UNDER GOVERNMENT ENTITLEMENT PROGRAMS SUCH AS MEDICARE AND MEDICAID. SUCH PROGRAMS PROVIDE PAYMENT FOR SERVICES OFTEN AT RATES THAT ARE SUBSTANTIALLY BELOW THE USUAL AND CUSTOMARY CHARGE. SEE ADDITIONAL INFORMATION ON THE COST OF THESE COMMUNITY BENEFITS PROVIDED IN SCHEDULE H OF THE FORM 990. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,734,822 | ExpenseAmt |
| Revenue | $7,100,979 | RevenueAmt |
| Desc | BALDWIN AREA MEDICAL CENTER, INC. ALSO PROVIDES OUTPATIENT HEALTHCARE SERVICES AT THREE LOCAL CLINICS THAT IT OPERATES. DURING FISCAL YEAR 2015, TOTAL OUTPATIENT ENCOUNTERS AT THESE CLINICS WERE 28,493. ONE OF THE THREE CLINICS IS DESIGNATED AS A PROVIDER-BASED RURAL HEALTH CLINIC.IN ADDITION, THE THREE CLINICS PROVIDED CHARITY CARE AND BAD DEBT EXPENSE FOR FISCAL YEAR 2015 IN THE AMOUNT OF $3,105 AND $52,605, RESPECTIVELY. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $396,303 | ExpenseAmt |
| Revenue | $148,366 | RevenueAmt |
| Desc | BALDWIN AREA MEDICAL CENTER, INC. HAS A FITNESS CENTER THAT IS OPEN TO ALL EMPLOYEES, PATIENTS, AND THE GENERAL PUBLIC. SINCE THEN, VOLUMES HAVE INCREASED DRAMATICALLY. THE CENTER HAS OVER 700 MEMBERS WITH MORE THAN 33,900 ANNUAL VISITS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $30,662,326 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 96 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 340 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRIAN LOVDAHL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7156843311 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 730 10TH AVENUE | AddressLine1Txt |
| City | BALDWIN | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 540020300 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MARY AABY | ||||||||
| DIRECTOR / CFO ADORAY HOME HEALTH | 1.00 | 24.00 | Yes (X) | $0 | $63,550 | $4,216 | ||
| CLINT SEMRAU DO | ||||||||
| DIRECTOR/SURGEON | 40.00 | Yes (X) | $379,345 | $0 | $37,156 | |||
| BARRY GRANT | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DANIELLE JOHNSON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JULIE HERMAN | ||||||||
| DIRECTOR | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| PATRICK HAYES | ||||||||
| CHAIRPERSON/PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| EILEEN LAFAVOR | ||||||||
| SECRETARY/TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| DANE RASMUSSEN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RON SILER | ||||||||
| VICE PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ALISON PAGE | ||||||||
| CEO | 50.00 | 1.00 | $258,978 | $0 | $32,916 | Yes (X) | ||
| BRIAN LOVDAHL | ||||||||
| CFO | 45.00 | 1.00 | $141,545 | $0 | $15,247 | Yes (X) | ||
| JOEL STOECKELER MD | ||||||||
| PHYSICIAN | 45.00 | $436,907 | $0 | $33,653 | Yes (X) | |||
| SHAIMA SULEMANKHIL MD | ||||||||
| PHYSICIAN | 45.00 | $417,067 | $0 | $42,638 | Yes (X) | |||
| SAMUEL INKUMSAH MD | ||||||||
| PHYSICIAN | 56.00 | $341,050 | $0 | $38,298 | Yes (X) | |||
| MARK ROMZEK MD | ||||||||
| SURGEON | 40.00 | $485,777 | $0 | $37,560 | Yes (X) | |||
| REID BERGER PA-C | ||||||||
| PHYSICIAN ASSISTANT | 45.00 | $253,343 | $0 | $22,204 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,714,012 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $63,550 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $263,888 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | 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 |
|---|---|---|---|---|---|
| ALLINA HEALTH SYSTEM | |||||
| NW 7710 PO BOX 9383 | MINNEAPOLIS | MN | 55440 | ER PHYSICIAN SERVICES / EKG / IT SERVICE | $2,252,468 |
| ANESTHETISTS INC OF WI | |||||
| PO BOX 159 2302 HWY 46 | DEER PARK | WI | 54007 | ANESTHESIA | $624,966 |
| CENTRAL MN DIAGNOSTIC IMAGING | |||||
| 150 10TH NW PO BOX 158 | MILACA | MN | 56353 | RADIOLOGY | $557,331 |
| SHARED MEDICAL SERVICES | |||||
| 209 LIMESTONE PASS | COTTAGE GROVE | MN | 53527 | NUCLEAR MEDICINE | $309,602 |
| QUEST DIAGNOSTICS | |||||
| PO BOX 12989 | CHICAGO | IL | 60693 | LAB SERVICES | $241,402 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $83,744 | GovernmentGrantsAmt |
| All Other Contributions | $524,946 | AllOtherContributionsAmt |
| Total Contributions | $608,690 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| PATIENT SERVICES REVENUE | 621400 | $35,489,307 | $35,486,603 | $2,704 | |
| OTHER HOSPITAL SERVICES/CAFETERIA | 621400 | $787,735 | $787,735 | ||
| WELLNESS CENTER REVENUE | 621400 | $148,366 | $148,366 | ||
| SCHOOL NURSING | 621400 | $69,179 | $69,179 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $36,494,587 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $140,505 | TotalRevenueColumnAmt |
| Exclusion | $140,505 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $71,927 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,660 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $68,267 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $68,267 | TotalRevenueColumnAmt |
| Exclusion | $68,267 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $773,219 | SecuritiesAmt |
| Other | $25,508 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $609,537 | SecuritiesAmt |
| Other | $157,190 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $163,682 | SecuritiesAmt |
| Other | -$131,682 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,000 | TotalRevenueColumnAmt |
| Exclusion | $32,000 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $37,611 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $16,820 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,791 | TotalRevenueColumnAmt |
| Exclusion | $20,791 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,364,840 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,704,148 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,704 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,049,298 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $500 | TotalAmt |
| Program Services | $500 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $457,703 | TotalAmt |
| Management And General | $457,703 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,323,416 | TotalAmt |
| Program Services | $13,930,463 | ProgramServicesAmt |
| Management And General | $2,392,953 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,831 | TotalAmt |
| Program Services | $298,547 | ProgramServicesAmt |
| Management And General | $51,284 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,948,624 | TotalAmt |
| Program Services | $1,662,963 | ProgramServicesAmt |
| Management And General | $285,661 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,093,776 | TotalAmt |
| Program Services | $909,843 | ProgramServicesAmt |
| Management And General | $183,933 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,160 | TotalAmt |
| Management And General | $39,160 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,705 | TotalAmt |
| Management And General | $37,705 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,450 | TotalAmt |
| Fundraising | $91,450 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,218,499 | TotalAmt |
| Program Services | $4,910,528 | ProgramServicesAmt |
| Management And General | $307,971 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,076 | TotalAmt |
| Management And General | $175,076 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $490,659 | TotalAmt |
| Program Services | $283,843 | ProgramServicesAmt |
| Management And General | $206,816 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $262,981 | TotalAmt |
| Management And General | $262,981 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $475,513 | TotalAmt |
| Program Services | $475,513 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,327 | TotalAmt |
| Program Services | $24,094 | ProgramServicesAmt |
| Management And General | $18,233 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,016 | TotalAmt |
| Management And General | $2,016 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,010,780 | TotalAmt |
| Program Services | $3,010,780 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $185,331 | TotalAmt |
| Management And General | $185,331 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES AND PH | $2,822,575 | $2,822,575 | |
| BAD DEBT EXPENSE | $1,380,673 | $1,380,673 | |
| MINOR EQUIPMENT AND REP | $626,548 | $596,723 | $29,825 |
| DUES AND SUBSCRIPTIONS | $115,270 | $47,570 | $67,700 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $549,874 | TotalAmt |
| Program Services | $307,711 | ProgramServicesAmt |
| Management And General | $242,163 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,700,287 | TotalAmt |
| Program Services | $30,662,326 | ProgramServicesAmt |
| Management And General | $4,946,511 | ManagementAndGeneralAmt |
| Fundraising | $91,450 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $328,578 | BOYAmt |
| EOY | $698,894 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,251,481 | BOYAmt |
| EOY | $5,131,596 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,756 | BOYAmt |
| EOY | $508,005 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,957,823 | BOYAmt |
| EOY | $5,383,111 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $683,126 | BOYAmt |
| EOY | $765,182 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $284,266 | BOYAmt |
| EOY | $490,942 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $39,286,979 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $18,092,321 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,997,908 | BOYAmt |
| EOY | $21,194,658 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,214,466 | BOYAmt |
| EOY | $4,455,551 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,426,112 | BOYAmt |
| EOY | $1,339,077 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,314,516 | BOYAmt |
| EOY | $39,967,016 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,903,963 | BOYAmt |
| EOY | $3,187,083 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $244,707 | BOYAmt |
| EOY | $360,134 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $473,958 | BOYAmt |
| EOY | $937,889 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,511,344 | BOYAmt |
| EOY | $6,000,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,113 | BOYAmt |
| EOY | $3,564,283 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $333,318 | BOYAmt |
| EOY | $416,232 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,528,403 | BOYAmt |
| EOY | $14,465,621 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,615,357 | BOYAmt |
| EOY | $24,993,390 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,756 | BOYAmt |
| EOY | $508,005 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,786,113 | BOYAmt |
| EOY | $25,501,395 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,314,516 | BOYAmt |
| EOY | $39,967,016 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,664,553 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$438,070 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $488,799 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule 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 | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $6,473 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $6,473 | 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 | BALDWIN AREA MEDICAL CENTER, INC. (THE "MEDICAL CENTER") PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. WHA AND AHA HAVE NOTIFIED THE MEDICAL CENTER THAT A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. THE MEDICAL CENTER IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, BAMC PAYS MEMBERSHIP FEES TO RWHC. RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST AND EMERGENCY ROOM PATIENT CARE COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO PROVIDES AN ANALYSIS ON CURRENT HEALTHCARE ISSUES IN AN EFFORT TO PROMOTE BETTER HEALTHCARE OPERATIONS FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON THE PART OF THE MEMBER ORGANIZATIONS. RWHC DETERMINED THAT A PORTION OF THE FEES PAID BY THE MEDICAL CENTER RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTHCARE ENVIRONMENT IN THE STATE OF WISCONSIN. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,545,088 | OtherCostOrOtherBasisAmt |
| Book Value | $2,545,088 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,929,586 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,849,425 | DepreciationAmt |
| Book Value | $13,080,161 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,271,538 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,242,896 | DepreciationAmt |
| Book Value | $3,028,642 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,540,767 | OtherCostOrOtherBasisAmt |
| Book Value | $2,540,767 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,194,658 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BOARD-DESIGNATED INVESTMENTS | Desc |
| Book Value | $4,455,551 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $4,455,551 | TotalBookValueProgramRltdAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION LIABILITY | $100,295 |
| 457(B) PLAN LIABILITY | $315,937 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $416,232 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | 0 | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | ActivityActivityTxt | Fundraiser Control Of FundsFundraiserControlOfFundsInd | Gross ReceiptsGrossReceiptsAmt | Retained By ContractorRetainedByContractorAmt | Net To OrganizationNetToOrganizationAmt |
|---|---|---|---|---|---|---|---|---|
| NEWDAY NONPROFIT SOLUTIONS LLC | ||||||||
| 1710 FENWICK AVE | EAU CLAIRE | WI | 54701 | CAPITAL CAMPAIGN ASSISTANCE | 0 | $597,596 | $83,000 | $514,596 |
| THE SWEENEY GROUP | ||||||||
| 88 OAK CREEK TRAIL | MADISON | WI | 53717 | CAPITAL CAMPAIGN ASSISTANCE | 0 | $72,000 | $8,575 | $63,425 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | $669,596 | TotalGrossReceiptsAmt |
| Total Retained By Contractors | $91,575 | TotalRetainedByContractorsAmt |
| Total Net To Organization | $578,021 | TotalNetToOrganizationAmt |
| Licensed States | WI | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF OUTING | Event1Nm |
| Gross Receipts Event1 | $20,330 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $20,330 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $8,041 | OtherDirectExpensesEvent1Amt |
| Event2 | AFTERNOON TEA | Event2Nm |
| Gross Receipts Event2 | $9,496 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $9,496 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $4,146 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 2 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $7,785 | GrossReceiptsOtherEventsAmt |
| Gross Revenue Other Events | $7,785 | GrossRevenueOtherEventsAmt |
| Oth Direct Expnss Other Events | $4,633 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $37,611 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $37,611 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $16,820 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $16,820 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $20,791 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 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 | $31,535 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $31,535 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,535 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $31,535 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $195,531 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $195,531 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00570 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,876,565 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,782,842 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,093,723 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11930 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,909 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,909 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,080,005 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,782,842 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,297,163 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12520 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,111,540 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,782,842 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,328,698 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12610 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $844,685 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $422,343 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $11,580,274 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,708,750 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$128,476 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | BALDWIN AREA MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 730 10TH AVENUE | AddressLine1Txt |
| City | BALDWIN | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54002 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.HEALTHYBALDWIN.ORG | WebsiteAddressTxt |
| State License | 1052 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BALDWIN AREA MEDICAL CENTER INC | 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 | SEE PART V, SECTION B, LINE 5D | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE PART V, SECTION B, LINE 5D | OtherWebsiteURLTxt |
| 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 | HTTP://WWW.HEALTHYBALDWIN.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.HEALTHYBALDWIN.ORG/VISIT/COMMUNITY-CARE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.HEALTHYBALDWIN.ORG/VISIT/COMMUNITY-CARE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| 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 (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BALDWIN AREA MEDICAL CENTER, INC. | PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) SOUGHT INPUT FROM DIVERSE STAKEHOLDERS, INCLUDING HEALTHCARE PROVIDERS, COMMUNITY LEADERS, AND THE PUBLIC. A SURVEY WAS CREATED AND COMPLETED BY 421 RESIDENTS OF ST. CROIX COUNTY, WHERE PARTICIPANTS IDENTIFIED THE HEALTH PRIORITIES THAT THEY FEEL ARE THE MOST IMPERATIVE TO ADDRESS IN THE ST. CROIX COUNTY REGION. |
| BALDWIN AREA MEDICAL CENTER, INC. | PART V, SECTION B, LINE 6A: CONDUCTED WITH: HUDSON HOSPITAL; HUDSON, WISCONSIN RIVER FALLS AREA HOSPITAL; RIVER FALLS, WISCONSIN WESTFIELDS HOSPITAL; NEW RICHMOND, WISCONSIN |
| BALDWIN AREA MEDICAL CENTER, INC. | PART V, SECTION B, LINE 6B: CONDUCTED WITH ST. CROIX COUNTY PUBLIC HEALTH DEPARTMENT |
| BALDWIN AREA MEDICAL CENTER, INC. | PART V, SECTION B, LINE 7D: THE CHNA CAN BE FOUND ON THE HOSPITAL WEBSITE AT: HTTP://WWW.HEALTHYBALDWIN.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/THE CHNA IS ALSO AVAILABLE ON THE VILLAGE OF BALDWIN AND THE BALDWIN CHAMBER OF COMMERCE WEBSITES.FINALLY, THE CHNA IS ALSO ATTACHED TO THE FORM 990 RETURN. |
| BALDWIN AREA MEDICAL CENTER, INC. | PART V, SECTION B, LINE 11: BALDWIN AREA MEDICAL CENTER, INC. IDENTIFIED SEVERAL NEEDS WHICH WERE PRIORITIZED AND INCLUDE THE FOLLOWING WHICH ARE CURRENTLY BEING ADDRESSED THROUGH EXISTING PROGRAMS AT THE HOSPITAL OR BY FUTURE INITIATIVES OR COLLABORATION WITH OTHER ORGANIZATIONS. THESE KEY HEALTH NEEDS IN THE COMMUNITY ARE OUTLINES ALONG WITH THEIR IMPLEMENTATION AND ACTION PLANS IN THE COMMUNITY HEALTH NEEDS ASSESSMENT POSTED ON THE MEDICAL CENTER'S WEBSITE:- PROMOTE INCREASING PHYSICAL ACTIVITY AND ACCESS TO NUTRITION RESOURCES TO PREVENT AND TREAT OBESITY- INCREASE ACCESS TO MENTAL HEALTH CARE- IMPROVE ACCESS TO PRIMARY AND PREVENTATIVE CARETHERE WERE ITEMS IDENTIFIED IN THE CHNA WHICH WERE NOT ADDRESSED BY BALDWIN AREA MEDICAL CENTER, INC.; HOWEVER, ALL ITEMS WERE CONSIDERED IF A NEED WAS BROUGHT TO THE ATTENTION OF THE GROUP DURING THE INFORMATION GATHERING PHASE OF THE CHNA PROCESS. THE ITEMS THAT WERE NOT ADDRESSED PRIMARILY WERE NOT ADDRESSED DUE TO THE FINANCIAL CONSTRAINT OF PROVIDING A NEW SERVICE FOR A LIMITED POPULATION OF PEOPLE WITHIN THE PRIMARY SERVICE AREA. ONE NEED THAT WAS IDENTIFIED BUT IS NOT BEING ADDRESSED INCLUDES IMPROVING ACCESS TO DENTISTRY. THIS NEED IS NOT CURRENTLY BEING ADDRESSED AS IT LIES BEYOND THE TRADITIONAL SCOPE OF CARE PROVIDED BY OUR MEDICAL CENTER AND MEDICAL STAFF. |
| BALDWIN AREA MEDICAL CENTER, INC. | PART V, SECTION B, LINE 16I: AVAILABILITY OF THE FAP IS ALSO PRINTED PATIENT BILLING STATEMENTS WHICH ARE MAILED MONTHLY TO ANY PATIENT HAVING A SELF PATIENT ACCOUNT BALANCE. |
| BALDWIN AREA MEDICAL CENTER, INC. | PART V, SECTION B, LINE 22D: ALL FAP-ELIGIBLE PATIENTS ARE CHARGED ACCORDING TO THE MEDICAL CENTER'S NORMAL CHARGEMASTER AND THEN DISCOUNTS ARE PROVIDED FROM THE STANDARD CHARGE BASED ON THE PATIENT'S DETERMINATION ACCORDING TO THE FINANCIAL AID DISCOUNT POLICY. ALL PRIVATE PAY PATIENTS ARE OFFERED A 10% DISCOUNT VIA LETTER IF THEY PAY THE ACCOUNT WITHIN THIRTY DAYS FROM THE DATE THEY RECEIVE THE LETTER EVEN IF A PATIENT DOES NOT QUALIFY FOR ASSISTANCE UNDER THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY. IN ADDITION TO THE PRIVATE PAY DISCOUNT NOTED ABOVE, PATIENTS THAT QUALIFY UNDER THE CHARITY CARE PROGRAM CAN BE ELIGIBLE FOR THE FOLLOWING DISCOUNTS:UN-INSURED PATIENTS:INCOME OR RESOURCE AVAILABILITY LEVEL: 0-100% OF FEDERAL POVERTY GUIDELINES (FPG)DISCOUNT PERCENTAGE: 100% INCOME OR RESOURCE AVAILABILITY LEVEL: 100-125% OF FPGDISCOUNT PERCENTAGE: 50%INCOME OR RESOURCE AVAILABILITY LEVEL: 126-150% OF FPGDISCOUNT PERCENTAGE: 20%INCOME OR RESOURCE AVAILABILITY LEVEL: 151-300% OF FPGDISCOUNT PERCENTAGE: 10%UNDER-INSURED PATIENTS:INCOME OR RESOURCE AVAILABILITY LEVEL: 0-100% OF FPGDISCOUNT PERCENTAGE: 100%INCOME OR RESOURCE AVAILABILITY LEVEL: 101-150% OF FPGDISCOUNT PERCENTAGE: 20%INCOME OR RESOURCE AVAILABILITY LEVEL: 151-300% OF FPGDISCOUNT PERCENTAGE: 10% |
| PART V, SECTION B, LINE 16 | FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY |
| BALDWIN AREA MEDICAL CENTER, INC. PART V, SECTION B, LINE 16B WEBSITE: | WWW.HEALTHYBALDWIN.ORG/VISIT/COMMUNITY-CARE |
| BALDWIN AREA MEDICAL CENTER, INC. PART V, SECTION B, LINE 16C WEBSITE: | WWW.HEALTHYBALDWIN.ORG/VISIT/COMMUNITY-CARE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| BALDWIN CLINIC | ||||
| 730 10TH AVENUE | BALDWIN | WI | 54002 | PROVIDER-BASED RURAL HEALTH CLINIC |
| ROBERTS MEDICAL CLINIC | ||||
| 503 CHERRY LANE | ROBERTS | WI | 54023 | PHYSICIAN CLINIC |
| HUDSON CLINIC | ||||
| 502 2ND ST | HUDSON | WI | 54016 | MENTAL HEALTH SERVICES OUTPATIENT CLINIC |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE MEDICAL CENTER'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. (THE COSTING METHODOLOGY FOR SUBSIDIZED HEALTH SERVICES FOR LINE 7G ON THE FIRST PAGE OF SCHEDULE H OF THE FORM 990 IS BASED ON COST ALLOCATIONS FROM THE MEDICARE COST REPORT. THIS ALLOCATION METHOD AND PRINCIPLES OF ALLOCATION WERE USED TO DERIVE A SPECIFIC AMOUNT OF COST ALLOCATION TO THE VARIOUS PROGRAMS AND COST CENTERS OPERATED BY BALDWIN AREA MEDICAL CENTER, INC.) |
| PART I, LINE 7G: | THE COST OF SUBSIDIZED HEALTH SERVICES IS BASED ON COST ALLOCATIONS FROM THE MEDICARE COST REPORT. ALLOWABLE COSTS ARE ASSIGNED DIRECTLY TO DEPARTMENTS THROUGHOUT THE YEAR AND THEN THE COST REPORT USES THE ALLOCATION METHODOLOGY TO ASSIGN ALL OTHER COSTS TO CALCULATE SERVICE LINE COSTS. SUBSIDIZED HEALTH SERVICES INCLUDE THE OPERATION OF THE ADULTS AND PEDIATRICS HOSPITAL INPATIENT UNIT, THE EMERGENCY DEPARTMENT, AND THE RURAL HEALTH CLINIC. THESE SERVICES ARE UNAVAILABLE TO MEMBERS OF THE COMMUNITY OTHER THAN THROUGH BALDWIN AREA MEDICAL CENTER, INC. IT IS THE GOAL OF BALDWIN AREA MEDICAL CENTER, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF THE PATIENT'S ABILITY TO PAY. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,380,673. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT", THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. BALDWIN AREA MEDICAL CENTER, INC. PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE MEDICAL CENTER BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. BALDWIN AREA MEDICAL CENTER, INC., LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, THE MEDICAL CENTER PROVIDES LOCAL ACCESS TO MANY SERVICES INCLUDING: BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES, INFUSION SERVICES, SWING-BED SERVICES, CLINICAL SERVICES, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SLEEP CENTER, SPEECH PATHOLOGY, SURGICAL SERVICES, WOUND CARE, BEHAVIORAL HEALTH, AND WOMEN'S SERVICES, TO NAME SOME OF THE MAJOR SERVICES PROVIDED. |
| PART III, LINE 2: | THE COSTING METHOD AND CALCULATIONS USED ON FORM 990 ARE BASED ON TOTAL OPERATING EXPENSES EXCLUDING BAD DEBT EXPENSE. THE COMMUNITY BENEFIT EXPENSE PERCENTAGES ARE CALCULATED BY DIVIDING THE COMMUNITY BENEFIT EXPENSE FOR EACH CATEGORY OF COMMUNITY SERVICES PROVIDED BY BALDWIN AREA MEDICAL CENTER, INC. REPORTED IN THE TABLE ON LINE 7 PART I OF THE SCHEDULE H BY THE TOTAL OPERATING EXPENSES OF THE MEDICAL CENTER LESS THE PROVISION FOR BAD DEBTS. |
| PART III, LINE 3: | MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKLIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUSTANDING AFTER THE MEDICAL CENTER HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. MANY TIMES PATIENTS DO NOT COMPLETE REQURIED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH THE MEDICAL CENTER PROVIDES THIS INFORMATION TO ALL PATIENTS AND PROVIDES ASSISSTANCE WITH THE APPLICATION. DUE TO NO RESPONSES FROM SOME PATIENTS A SIGNIFICANT AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE AND THE MEDICAL CENTER HAS REFLECTED AN AMOUNT OF THESE ADDITIONAL BAD DEBTS IN PART III OF SCHEDULE H OF THE 990. |
| PART III, LINE 4: | IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, BALDWIN AREA MEDICAL CENTER, INC. ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF PATIENT REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, BALDWIN AREA MEDICAL CENTER, INC. ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR 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), BALDWIN AREA MEDICAL CENTER, INC. 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 UNCOLLECTIBLE ACCOUNTS.THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. |
| PART III, LINE 8: | THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H TO THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE MEDICAL CENTER, AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE MEDICAL CENTER AS WELL AS HOSPITAL INPATIENT PHYSICIAN PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN PROFESSIONAL SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENTS AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND PHYSICIAN SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT BALDWIN AREA MEDICAL CENTER, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED SEPTEMBER 30, 2015, AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES, AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE).WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. |
| PART III, LINE 9B: | UNDER THE MEDICAL CENTER'S COLLECTION AND CHARITY CARE POLICIES, BALDWIN AREA MEDICAL CENTER, INC. MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE MEDICAL CENTER'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. ALL INPATIENT SELF-PAY ADMISSIONS ARE SCREENED BY THE MEDICAL CENTER'S PATIENT FINANCIAL COUNSELOR OR SOCIAL WORKERS TO ALLOW THESE PATIENTS THE ABILITY TO COMPLETE THEIR APPLICATION DURING THEIR STAY AT THE MEDICAL CENTER, DEPENDING UPON THE PATIENT'S CONDITION, THE PATIENT'S RESPONSIBLE PARTY MAY BE CONTACTED TO COMPLETE AND RETURN THE FORMS AT A LATER TIME WHEN THEIR CARE ALLOWS THIS COMPLETION. DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE MEDICAL CENTER'S COLLECTION POLICIES AS WELL AS THE CHARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM. |
| PART VI, LINE 2: | BALDWIN AREA MEDICAL CENTER, INC. ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITIES AND AREAS IT SERVES BY REVIEWING LOCAL DEMOGRAPHICS AND TRENDS IN PATIENT SERVICE UTILIZATION TO DETERMINE WHICH SERVICES COULD AND SHOULD BE MADE AVAILABLE TO THE COMMUNITY IN A COST-EFFECTIVE MANNER. BALDWIN AREA MEDICAL CENTER, INC. IS ALSO A PARTICIPATING MEMBER IN HEALTHIER TOGETHER-ST. CROIX COUNTY, A GROUP IN WHICH LOCAL HOSPITALS, PUBLIC HEALTH, OTHER HEALTH RELATED AND GOVERNMENT ENTITIES, AND COMMUNITY MEMBERS IN ST. CROIX COUNTY WORK TOGETHER TO BETTER UNDERSTAND THE CURRENT AND FUTURE HEALTH NEEDS OF ST. CROIX COUNTY. THE HEALTHIER-TOGETHER-ST. CROIX COUNTY TEAM FOLLOWS THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S (CDC) COMMUNITY HEALTH ASSESSMENT AND GROUP EVALUATION (CHANGE) TOOL, WHICH WAS DESIGNED TO HELP COMMUNITIES DEVELOP AN ACTION PLAN THROUGH ASSESSMENT AND PRIORTIZATION. |
| PART VI, LINE 3: | UNINSURED AND UNDERINSURED PATIENTS ARE ASKED TO MEET WITH THE MEDICAL CENTER'S FINANCIAL COUNSELOR EITHER AT THE TIME SERVICE IS PROVIDED OR WHEN THE PATIENT'S BILL IS GENERATED. THE FINANCIAL COUNSELOR EXPLAINS THE VARIOUS PAYMENT OPTIONS AVAILABLE TO THE PATIENT AS WELL AS THE MEDICAL CENTER'S CHARITY CARE PROGRAM AND OFFERS THE CHARITY CARE APPLICATION WHEN APPROPRIATE. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE WISCONSIN MEDICAID OR BADGERCARE PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE. |
| PART VI, LINE 4: | BALDWIN AREA MEDICAL CENTER, INC. IS LOCATED IN ST. CROIX COUNTY. BALDWIN AREA MEDICAL CENTER, INC.'S PRIMARY SERVICE AREA INCLUDES COMMUNITIES WITHIN A 25 MILE RADIUS. |
| PART VI, LINE 5: | BALDWIN AREA MEDICAL CENTER, INC. IS ENGAGED IN MANY ASPECTS OF PROMOTING COMMUNITY HEALTH. NURSING STAFF FROM THE MEDICAL CENTER STAFF THE LOCAL SCHOOL DISTRICT NURSING OFFICE. OUR PHYSICIANS SERVE AS MEDICAL DIRECTORS FOR SCHOOL DISTRICTS IN OUR SERVICE AREA. THROUGHOUT THE YEAR, BALDWIN AREA MEDICAL CENTER, INC. OFFERS EDUCATIONAL SESSIONS OPEN TO ALL COMMUNITY MEMBERS ON A BROAD RANGE OF HEALTH AND MEDICAL TOPICS SUCH AS HEART HEALTH, PAIN MANAGEMENT, EMOTIONAL WELL-BEING, END OF LIFE PLANNING, CAR SEAT SAFETY, AND MUCH MORE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI |
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 | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CLINT SEMRAU DO | ||||||||||||||
| DIRECTOR/SURGEON | $379,345 | $0 | $0 | $0 | $0 | $0 | $7,800 | $0 | $29,356 | $0 | $416,501 | $0 | $0 | $0 |
| ALISON PAGE | ||||||||||||||
| CEO | $258,978 | $0 | $0 | $0 | $0 | $0 | $7,800 | $0 | $25,116 | $0 | $291,894 | $0 | $0 | $0 |
| BRIAN LOVDAHL | ||||||||||||||
| CFO | $141,545 | $0 | $0 | $0 | $0 | $0 | $4,278 | $0 | $10,969 | $0 | $156,792 | $0 | $0 | $0 |
| JOEL STOECKELER MD | ||||||||||||||
| PHYSICIAN | $436,907 | $0 | $0 | $0 | $0 | $0 | $7,800 | $0 | $25,853 | $0 | $470,560 | $0 | $0 | $0 |
| SHAIMA SULEMANKHIL MD | ||||||||||||||
| PHYSICIAN | $417,067 | $0 | $0 | $0 | $0 | $0 | $7,800 | $0 | $34,838 | $0 | $459,705 | $0 | $0 | $0 |
| SAMUEL INKUMSAH MD | ||||||||||||||
| PHYSICIAN | $341,050 | $0 | $0 | $0 | $0 | $0 | $7,800 | $0 | $30,498 | $0 | $379,348 | $0 | $0 | $0 |
| MARK ROMZEK MD | ||||||||||||||
| SURGEON | $485,777 | $0 | $0 | $0 | $0 | $0 | $6,935 | $0 | $30,625 | $0 | $523,337 | $0 | $0 | $0 |
| REID BERGER PA-C | ||||||||||||||
| PHYSICIAN ASSISTANT | $253,343 | $0 | $0 | $0 | $0 | $0 | $7,600 | $0 | $14,604 | $0 | $275,547 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | THE MEDICAL CENTER HAS ESTABLISHED A DEFERRED COMPENSATION ARRANGEMENT MADE TO THE PLAN BY EXECUTIVE LEVEL EMPLOYEES AND MEDICAL PROVIDERS. EMPLOYEES INCLUDED IN SCHEDULE J TO THE FORM 990 WHO CONTIBUTED TO THE DEFERRED COMPENSATION PLAN INCLUDED: ALISON PAGE; JOEL STOECKLER, MD; SHAIMA SULEMANKHIL, MD; SAMUEL INKUMSAH, MD; AND MARK ROMZEK, MD. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BALDWIN VILLAGE OF | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 396006200 | BondIssuerEIN |
| Bond Issued | 2014-11-14 | BondIssuedDt |
| Issue Price | $6,000,000 | IssuePriceAmt |
| Purpose | HOSPITAL CONSTRUCTION | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $6,000,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $161,527 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $5,838,473 | OtherSpentProceedsAmt |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | BALDWIN AREA MEDICAL CENTER IS EXPANDING SERVICES TO BUSINESSES IN TEH COMMUNITIES SERVED. THESE SERVICES INCLUDED HEALTH SCREENING, EDUCATION, PRE-EMPLOYMENT SCREENING AND WORKPLACE EVALUATION. ALSO, A COMPREHENSIVE SET OF SERVICES TO MANAGE CHRONIC PAIN HAS BEEN DEVELOPED AND LAUNCHED BY BALDWIN AREA MEDICAL CENTER. THE PROGRAM IS MANAGED BY THE PHYSICAL THERAPY DEPARTMENT. THE PROGREM IS INTENDED TO REDUCE THE RELIANCE ON ADDICTIVE PAIN KILLERS FOR PEOPLE SUFFERING FROM CHRONIC PAIN. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED BY BALDWIN AREA MEDICAL CENTER, INC.'S MANAGEMENT. THE FORM 990 IS ALSO PROVIDED TO THE BOARD MEMBERS FOR REVIEW AND FINAL APPROVAL PRIOR TO FILING THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS DISCUSSED AT THE ANNUAL MEETING, AND BOARD MEMBERS ARE REQUIRED TO REVIEW, UPDATE, AND SIGN ANNUAL DISCLOSURE STATEMENTS. THE BOARD CHAIR MONITORS FOR CONFLICTS AND ANY BOARD MEMBERS WITH KNOWN CONFLICTS ARE ASKED TO REFRAIN FROM VOTING ON THOSE CONFLICTED ITEMS. |
| FORM 990, PART VI, SECTION B, LINE 15 | FOR ALL POSITIONS, SALARY SURVEYS ARE COMPLETED BY BALDWIN AREA MEDICAL CENTER, INC. AND THE DATA IS COLLECTED BY A THIRD-PARTY. THE REVIEW OF THE DATA IS CONDUCTED BY BALDWIN AREA MEDICAL CENTER, INC. IN THE CASE OF THE CEO, THE DATA IS REVIEWED BY THE BOARD CHAIR AND EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS WHO DETERMINE WHAT THE CEO RECEIVES FOR A SALARY INCREASE. SENIOR MANAGER POSITIONS ARE REVIEWED BY THE CEO WHO MAKES THE FINAL DECISION AS TO THE INCREASE AMOUNT OR WAGE ADJUSTMENT. HOWEVER, IN THE MAJORITY OF INSTANCES IT HAS BEEN BASED UPON WHAT THE MEDICAL CENTER CAN AFFORD, WHICH HAS BEEN HELD LOWER THAN SUGGESTED MARKET OR MERIT INCREASES. FOR ALL OTHER POSITIONS, THE HUMAN RESOURCES DIRECTOR MAKES THE RECOMMENDATION AND THE SENIOR MANAGER REVIEWS THE RECOMMENDATION AND FINALLY THE ENTIRE PLAN IS REVIEWED BY THE CEO. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | EMERGENCY ROOM PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,282,212. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,282,212. LAB PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 347,391. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 347,391. RADIOLOGY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,173,790. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,173,790. ANESTHESIA PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 667,653. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 667,653. CLINIC CONTRACTED PHYSICIANS: PROGRAM SERVICE EXPENSES 218,208. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 218,208. PHARMACY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 497,941. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 497,941. HOUSEKEEPING/LAUNDRY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 76,064. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 76,064. EKG PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 254,240. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 254,240. OB PHYSICIAN CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 182,530. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 182,530. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 210,499. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 210,499. ADMINISTRATIVE PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 307,971. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 307,971. |
| FORM 990, PART XI, LINE 9: | INCREASE IN EQUITY OF UNCONSOLIDATED AFFILIATES 151,550. REMOVAL OF INVESTMENT IN ADORAY 0. INCREASE IN PLEDGES RECEIVABLE 337,249. |
| FORM 990, PART XII, LINE 2C, SELECTION OF INDEPENDENT ACCOUNTANT: | THE MEDICAL CENTER ANSWERED "YES" TO QUESTION 2C UNDER PART XII OF THE 990, INDICATING THAT THE MEDICAL CENTER DOES HAVE A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE FULL BOARD OF DIRECTORS REVIEWS THE FINANCIAL STATEMENTS AND LISTENS TO THE AUDIT FIRM PRESENTATION. MEMBERS OF THE BOARD ALSO ARE GIVEN ACCESS TO THE AUDIT FIRM THROUGHOUT THE YEAR AND ARE ALLOWED THE OPPORTUNITY TO MEET WITH THE AUDITORS WITHOUT MANAGEMENT PRESENT DURING THE ANNUAL FINANCIAL STATEMENT PRESENTATION. THERE WERE NO CHANGES TO THESE PROCEDURES IN FISCAL YEAR 2015. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CROIX VALLEY SHARED SERVICES INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2231 HWY 12 | AddressLine1Txt |
| City | BALDWIN | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 540029248 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391791601 | EIN |
| Primary Activities | HOME HEALTH AND HOSPICE | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 9 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | 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 | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CROIX VALLEY SHARED SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | D | TransactionTypeTxt |
| Involved | $122,070 | InvolvedAmt |
| Method Of Amount Determination | 81.38% OF LOC BALANCE AT 09/30/15 | MethodOfAmountDeterminationTxt |
Comments