PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC (EIN 39-0910727)
Tax period
2013-10-01 to 2014-09-30
Filed
2015-08-07
IRS object ID
201502199349300800
Schema version
2013v4.0
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)
Return2015-08-07T08:22:19-05:00ReturnTs
Tax Period End2014-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN381357951PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 307AddressLine1
CitySOUTHFIELDCity
StateMIState
ZIP Code480370307ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390910727EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WAUKESHA MEMORIAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlWAUKBusinessNameControlTxt
Phone2629282496PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1725 AMERICAN AVENUEAddressLine1
CityWAUKESHACity
StateWIState
ZIP Code53188ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRONALD FARRPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone2629282496PhoneNum
Signature2015-07-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID LOWENTHALPreparerPersonNm
PTINP00378651PTIN
Phone2483522500PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSUSAN EDWARDSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1725 AMERICAN AVENUEAddressLine1
CityWAUKESHACity
StateWIState
ZIP Code53188ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$479,221,980GrossReceiptsAmt
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 Body23VotingMembersGoverningBodyCnt
Voting Members Independent21VotingMembersIndependentCnt
Total Employee2906TotalEmployeeCnt
Total Volunteers458TotalVolunteersCnt
Total Gross UBI$2,791,380TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$1,152,945NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,424,641PYContributionsGrantsAmt
CY Contributions Grants$1,591,390CYContributionsGrantsAmt
PY Program Service Revenue$431,462,556PYProgramServiceRevenueAmt
CY Program Service Revenue$441,706,467CYProgramServiceRevenueAmt
PY Investment Income$33,254,390PYInvestmentIncomeAmt
CY Investment Income$33,906,585CYInvestmentIncomeAmt
PY Other Revenue$1,787,006PYOtherRevenueAmt
CY Other Revenue$1,987,278CYOtherRevenueAmt
PY Total Revenue$467,928,593PYTotalRevenueAmt
CY Total Revenue$479,191,720CYTotalRevenueAmt
PY Grants And Similar Paid$20,374,573PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$17,933,881CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$139,172,445PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$135,938,150CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$257,795,231PYOtherExpensesAmt
CY Other Expenses$276,341,058CYOtherExpensesAmt
PY Total Expenses$417,342,249PYTotalExpensesAmt
CY Total Expenses$430,213,089CYTotalExpensesAmt
PY Revenues Less Expenses$50,586,344PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$48,978,631CYRevenuesLessExpensesAmt
Total Assets BOY$805,868,769TotalAssetsBOYAmt
Total Assets EOY$528,328,373TotalAssetsEOYAmt
Total Liabilities BOY$316,340,282TotalLiabilitiesBOYAmt
Total Liabilities EOY$342,943,200TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$489,528,487NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$185,385,173NetAssetsOrFundBalancesEOYAmt
MissionCONTINUOUSLY IMPROVING THE HEALTH OF OUR COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$402,502,572ExpenseAmt
Grant$17,933,881GrantAmt
Revenue$438,935,497RevenueAmt
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 56,307 DAYS OF INPATIENT CARE AND APPROXIMATELY 280,694 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2014. SEE SCHEDULE H FOR ILLUSTRATION OF ITS PROGRAM SERVICE ACCOMPLISHMENTS.Desc
Total Program Service Expenses$402,502,572TotalProgramServiceExpensesAmt
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 AssetsYes (1)ReportOtherAssetsInd
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 EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial LiquidationYes (1)PartialLiquidationInd
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 Document275IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee2906EmployeeCnt
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 Members23GoverningBodyVotingMembersCnt
Independent Voting Member21IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
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 SUITEAddressLine1
CityWAUKESHACity
StateWIState
ZIP Code531881131ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (37 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
SUSAN EDWARDS
CEO - PHC2.0050.00Yes (X)Yes (X)$0$960,406$768,577
GARY BEYER MD
CHAIRMAN2.004.00Yes (X)Yes (X)$0$0$0
TED GARVEY
VICE CHAIRPERSON2.004.00Yes (X)Yes (X)$0$0$0
EILEEN GILLESPIE
SECRETARY - PART YEAR2.004.00Yes (X)Yes (X)$0$0$0
ED LUMP
TREASURER2.004.00Yes (X)Yes (X)$0$0$0
CHARLOTTE HALL
SECRETARY2.004.00Yes (X)Yes (X)$0$0$0
JIM GANNON
TREASURER - PHC BOARD1.004.00Yes (X)Yes (X)$0$0$0
TOM PACKEE
SECRETARY - PHC BOARD1.004.00Yes (X)Yes (X)$0$0$0
JOHN RAASCH
VICE CHAIRPERSON-PART YEAR/DIRECTOR1.004.00Yes (X)Yes (X)$0$0$0
JOHN ROBERTSTAD
PRESIDENT - PHC HOSPITAL DIVISION32.0012.00Yes (X)Yes (X)$544,252$0$70,799
JANET SWANDBY
CHAIRPERSON - PHC BOARD1.004.00Yes (X)Yes (X)$0$0$0
HELEN FORSTER
VICE CHAIRPERSON1.004.00Yes (X)Yes (X)$0$0$0
MIKE BARRY
DIRECTOR - PART YEAR2.004.00Yes (X)$0$0$0
PAUL BOSTROM
DIRECTOR2.004.00Yes (X)$0$0$0
CLIFF BROOKS
DIRECTOR2.004.00Yes (X)$0$0$0
DOUG BRUINS
DIRECTOR2.004.00Yes (X)$0$0$0
RICHARD NEILS
DIRECTOR - PART YEAR2.004.00Yes (X)$0$0$0
ARCH PEQUET
DIRECTOR2.004.00Yes (X)$0$0$0
TIM WESTLAKE
DIRECTOR2.004.00Yes (X)$0$0$0
BETTY ARNDT
DIRECTOR - PHC BOARD1.004.00Yes (X)$0$0$0
DIXON BENZ
DIRECTOR - PHC BOARD - PART YEAR1.004.00Yes (X)$0$0$0
DOUG HASTAD
DIRECTOR - PHC BOARD1.004.00Yes (X)$0$0$0
MARK MOHR
DIRECTOR - PHC BOARD1.004.00Yes (X)$0$0$0
ELLEN MURPHY
DIRECTOR - PHC BOARD1.004.00Yes (X)$0$0$0
RALPH RAMIREZ
DIRECTOR - PHC BOARD1.004.00Yes (X)$0$0$0
DAVID ROELKE
DIRECTOR - PHC BOARD1.004.00Yes (X)$0$0$0
JULIE SCHROEDER
DIRECTOR - PHC BOARD1.004.00Yes (X)$0$0$0
DAVID EBEL
INTERIM CFO2.0050.00Yes (X)$0$0$0
NANINE NELSON
CFO - PHC - PART YEAR2.0050.00Yes (X)$0$410,111$23,345
RONALD FARR
CFO2.0050.00Yes (X)$0$0$0
JAMES GARDNER
VP MEDICAL AFFAIRS40.000.00$436,733$0$59,230Yes (X)
KENNETH PRICE
CHIEF ADMIN OFFICER32.000.00$195,730$117,367$48,169Yes (X)
ERIC HENDEE
CHIEF PHYSICIST - RADIOLOGY40.000.00$195,730$0$41,574Yes (X)
MOHAMMAD KHARBAT
DIRECTOR PHARMACY40.000.00$183,560$0$29,933Yes (X)
LINDA TREVINO
CLINICAL NURSE II40.000.00$150,791$861$2,653Yes (X)
MICHAEL KOWALOK
PHYSICIST40.000.00$173,242$0$14,269Yes (X)
JEAN MCDONALD
DIRECTOR ONCOLOGY-WOMEN'S SERVICES40.000.00$156,118$0$14,477Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,036,156TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,488,745TotReportableCompRltdOrgAmt
Total Other Compensation$1,073,026TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K70IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
RILEY CONSTRUCTION CO INC
5301-99TH AVEKENOSHAWI53144CONSTRUCTION SERVICES$10,387,143
FINDORFF INC
PO BOX 575MADISONWI53701CONSTRUCTION SERVICES$5,403,668
EPIC SYSTEMS CORP
PO BOX 88314MILWAUKEEWI53288EMR SERVICE PROVIDER$3,666,148
MEDICAL COLLEGE OF WI
PO BOX 13308MILWAUKEEWI53213PROVIDER SERVICES$3,484,023
TW TELECOM
PO BOX 172567DENVERCO80217INTERNET PHONE CABLE PROVIDER$1,652,997
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K70CntrctRcvdGreaterThan100KCnt
Related Organizations$1,396,440RelatedOrganizationsAmt
All Other Contributions$194,950AllOtherContributionsAmt
Total Contributions$1,591,390TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT REV.622110$423,577,723$423,577,723
MEDICAL SERVICE LAB621500$8,403,170$5,632,200$2,770,970
HOSPITAL JOINT VENTURE622310$2,170,778$2,170,778
MEANINGFUL USE900099$1,946,867$1,946,867
SURGERY CENTERS621400$1,844,766$1,844,766

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,763,163TotalRevenueColumnAmt
Related Or Exempt Func Income$3,763,163RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$441,706,467TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$33,875,643TotalRevenueColumnAmt
Exclusion$33,875,643ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Personal$46,273PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Personal$14,343PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Personal$31,930PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$31,930TotalRevenueColumnAmt
Unrelated Business Revenue$20,410UnrelatedBusinessRevenueAmt
Exclusion$11,520ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$46,859OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$15,917OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$30,942OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$30,942TotalRevenueColumnAmt
Exclusion$30,942ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA722210$1,925,613$1,925,613
GIFT SHOP453220$29,735$29,735
FieldValueIRS element (for citing)
Other Revenue Total$1,955,348OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$479,191,720TotalRevenueColumnAmt
Related Or Exempt Func Income$438,935,497RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$2,791,380UnrelatedBusinessRevenueAmt
Exclusion$35,873,453ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$17,933,881TotalAmt
Program Services$17,933,881ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,082,001TotalAmt
Management And General$3,082,001ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$99,768,710TotalAmt
Program Services$98,039,748ProgramServicesAmt
Management And General$1,728,962ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$7,450,804TotalAmt
Program Services$7,102,284ProgramServicesAmt
Management And General$348,520ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$18,281,693TotalAmt
Program Services$17,426,545ProgramServicesAmt
Management And General$855,148ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$7,354,942TotalAmt
Program Services$7,028,367ProgramServicesAmt
Management And General$326,575ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$122,242,958TotalAmt
Program Services$102,922,696ProgramServicesAmt
Management And General$19,320,262ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$14,990,950TotalAmt
Program Services$14,981,833ProgramServicesAmt
Management And General$9,117ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$5,026,847TotalAmt
Program Services$4,665,793ProgramServicesAmt
Management And General$361,054ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$11,895,614TotalAmt
Program Services$11,895,614ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$35,193,744TotalAmt
Program Services$35,193,744ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$34,331,120$34,331,031$89
DRUGS & PHARMACEUTICALS$22,520,402$22,520,402
MEDICAID PROVIDER TAXES$13,465,153$13,465,153
BAD DEBTS$11,754,492$11,754,492

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$4,919,778TotalAmt
Program Services$3,240,989ProgramServicesAmt
Management And General$1,678,789ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$430,213,089TotalAmt
Program Services$402,502,572ProgramServicesAmt
Management And General$27,710,517ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$512,250BOYAmt
EOY$894,111EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$10,461,182BOYAmt
EOY$18,156,414EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$56,552,150BOYAmt
EOY$53,274,339EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$8,036,858BOYAmt
EOY$7,577,164EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$5,489,553BOYAmt
EOY$6,189,834EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$759,670,369LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$442,688,147LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$278,824,420BOYAmt
EOY$316,982,222EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$310,964,639BOYAmt
EOY$28,326,631EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$9,278,045BOYAmt
EOY$9,662,324EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$125,749,672BOYAmt
EOY$87,265,334EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$805,868,769BOYAmt
EOY$528,328,373EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$42,391,690BOYAmt
EOY$68,714,984EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$195,427,377BOYAmt
EOY$188,849,190EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$33,441,881BOYAmt
EOY$32,856,868EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$45,079,334BOYAmt
EOY$52,522,158EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$316,340,282BOYAmt
EOY$342,943,200EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$488,784,731BOYAmt
EOY$184,716,962EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$743,756BOYAmt
EOY$668,211EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$489,528,487BOYAmt
EOY$185,385,173EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$805,868,769BOYAmt
EOY$528,328,373EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$48,978,631ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$10,615,300NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$363,737,245OtherChangesInNetAssetsAmt
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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,498,739BeginningYearBalanceAmt
Contributions$1,045,116ContributionsAmt
Investment Earnings Or Losses-$1,820InvestmentEarningsOrLossesAmt
End Year Balance$6,542,035EndYearBalanceAmt
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$23,062,875OtherCostOrOtherBasisAmt
Book Value$23,062,875BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$320,065,173OtherCostOrOtherBasisAmt
Depreciation$160,690,475DepreciationAmt
Book Value$159,374,698BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,711,381OtherCostOrOtherBasisAmt
Depreciation$2,541,178DepreciationAmt
Book Value$170,203BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$361,838,302OtherCostOrOtherBasisAmt
Depreciation$279,456,494DepreciationAmt
Book Value$82,381,808BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$51,992,638OtherCostOrOtherBasisAmt
Book Value$51,992,638BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$316,982,222TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDescBook ValueBookValueAmt
DEFERRED FINANCING$1,180,435
DEBT SERVICE RESERVE FUND-$811,576
ACCRUED INTEREST RECEIVABLE$480,314
DUE FROM AFFILIATES$16,993,024
OTHER ASSETS$3,217,633
DEPRECIATION RESERVE$66,205,504
FieldValueIRS element (for citing)
Total Book Value Other Assets$87,265,334TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
ACCRUED POSTRETIREMENT MEDICAL$85,385
FAIR VALUE-INTEREST RATE SWAP$18,302,147
ASSET RETIREMENT OBLIGATION$114,228
ACCUMULATED MIN PENSION LIABILITY$34,020,398
FieldValueIRS element (for citing)
Total Liability$52,522,158TotalLiabilityAmt
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, PHCMA, 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. 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, 2014, 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. THE CORPORATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS AND IS CURRENTLY BEING AUDITED FOR THE 2012 TAX PERIOD FOR WAUKESHA MEMORIAL HOSPITAL, INC. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2011.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$3,369,953TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,369,953NetCommunityBenefitExpnsAmt
Total Expense0.00810TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$40,527,565TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$22,535,922DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,991,643NetCommunityBenefitExpnsAmt
Total Expense0.04300TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$43,897,518TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$22,535,922DirectOffsettingRevenueAmt
Net Community Benefit Expns$21,361,596NetCommunityBenefitExpnsAmt
Total Expense0.05110TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs32ActivitiesOrProgramsCnt
Persons Served46095PersonsServedCnt
Total Community Benefit Expns$6,005,126TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$94,261DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,910,865NetCommunityBenefitExpnsAmt
Total Expense0.01410TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs9ActivitiesOrProgramsCnt
Persons Served1955PersonsServedCnt
Total Community Benefit Expns$6,359,330TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,943,997DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,415,333NetCommunityBenefitExpnsAmt
Total Expense0.00580TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Total Community Benefit Expns$4,656,180TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,087,138DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,569,042NetCommunityBenefitExpnsAmt
Total Expense0.00610TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$507,944TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$507,944NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs8ActivitiesOrProgramsCnt
Persons Served13715PersonsServedCnt
Total Community Benefit Expns$1,442,236TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$131,303DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,310,933NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs52ActivitiesOrProgramsCnt
Persons Served61765PersonsServedCnt
Total Community Benefit Expns$18,970,816TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,256,699DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,714,117NetCommunityBenefitExpnsAmt
Total Expense0.03030TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs52ActivitiesOrProgramsCnt
Persons Served61765PersonsServedCnt
Total Community Benefit Expns$62,868,334TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$28,792,621DirectOffsettingRevenueAmt
Net Community Benefit Expns$34,075,713NetCommunityBenefitExpnsAmt
Total Expense0.08140TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served387PersonsServedCnt
Total Community Benefit Expns$23,526TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$23,526NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served471PersonsServedCnt
Total Community Benefit Expns$34,206TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$34,206NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served117PersonsServedCnt
Total Community Benefit Expns$10,979TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$22DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,957NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served83PersonsServedCnt
Total Community Benefit Expns$391TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$391NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served1127PersonsServedCnt
Total Community Benefit Expns$11,780TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$11,780NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served12PersonsServedCnt
Total Community Benefit Expns$28,548TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$28,548NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs6ActivitiesOrProgramsCnt
Persons Served2197PersonsServedCnt
Total Community Benefit Expns$109,430TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$22DirectOffsettingRevenueAmt
Net Community Benefit Expns$109,408NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$11,794,015BadDebtExpenseAmt
Bad Debt Expense Attributable$1,149,089BadDebtExpenseAttributableAmt
Reimbursed By Medicare$83,449,176ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$148,220,379CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$64,771,203MedicareSurplusOrShortfallAmt

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 SERVICES0.300000.70000
FieldValueIRS element (for citing)
Hospital Facilities2HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndTeaching HospitalTeachingHospitalIndEmergency Room OtherEmergencyRoomOtherIndOtherOtherDesc
WAUKESHA MEMORIAL HOSPITAL INC
1725 AMERICAN AVENUEWAUKESHAWI53188Yes (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)

FacilityFacilityNumCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndExisting ResourcesExistingResourcesIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndOtherOtherIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndOwn Website URLOwnWebsiteURLTxtRpt Available Upon RequestRptAvailableUponRequestIndAdopt Implementation StrategyAdoptImplementationStrategyIndExec Implementation StrategyExecImplementationStrategyIndDevelop Community Wide PlanDevelopCommunityWidePlanIndExec Community Wide PlanExecCommunityWidePlanIndInclude Operational PlanIncludeOperationalPlanIndAdopt BudgetAdoptBudgetIndPrioritize Health NeedsPrioritizeHealthNeedsIndPrioritize ServicesPrioritizeServicesIndAll Needs AddressedAllNeedsAddressedIndOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Used Deter Elig Free CareFPGUsedDeterEligFreeCareIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctFPG Used Determ Elig Dscnt CareFPGUsedDetermEligDscntCareIndFPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePctExplained BasisExplainedBasisIndIncome LevelIncomeLevelIndAsset LevelAssetLevelIndMedical IndigencyMedicalIndigencyIndInsurance StatusInsuranceStatusIndUninsured DiscountUninsuredDiscountIndApp Financial Asst ExplnAppFinancialAsstExplnIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndPosted On WebsitePostedOnWebsiteIndAttached To InvoiceAttachedToInvoiceIndPosted In Emergency RoomPostedInEmergencyRoomIndPosted In Admission OfficePostedInAdmissionOfficeIndProvided On AdmissionProvidedOnAdmissionIndAvailable On RequestAvailableOnRequestIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndCollection ActivitiesCollectionActivitiesIndFAP Notified All PatientsFAPNotifiedAllPatientsIndDocumented Elig DeterminationDocumentedEligDeterminationIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndAverage Negotiated RatesAverageNegotiatedRatesIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesIndOther PublicityOtherPublicityIndOther Method UsedOtherMethodUsedInd
WAUKESHA MEMORIAL HOSPITAL INC
1Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)13Yes (1)Yes (1)Yes (1)Yes (X)FULL WEBSITE LISTED IN PART V SECTION CYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)00Yes (1)Yes (1)200.000000000000Yes (1)400.000000000000Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)0Yes (X)Yes (X)Yes (1)Yes (X)00
REHABILITATION HOSPITAL OF WISCONSIN LLC
20Yes (1)Yes (1)150.000000000000Yes (1)250.000000000000Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (1)0Yes (X)Yes (X)Yes (1)00Yes (X)Yes (X)

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 1J: WAUKESHA MEMORIAL HOSPITAL'S CHNA ALSO INCLUDES INFORMATION ABOUT ITS ACTIVE PARTICIPATION AND PARTNERSHIP IN THE WAUKESHA COUNTY HEALTH AND HUMAN SERVICES CHIPP (COMMUNITY HEALTH IMPROVEMENT PLAN AND PROCESS).
WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 5D: THE CHNA IS AVAILABLE AT WWW.PROHEALTHCARE.ORG/ABOUT-US-COMMUNITY-BENEFIT.ASPX
WAUKESHA MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 7: ADDITIONAL COMMUNITY NEEDS IDENTIFIED INCLUDED MENTAL HEALTH, AODA AND ACCESS TO CARE. AS THESE ARE THE NEEDS CHOSEN BY THE WAUKESHA COUNTY HHS, WE CHOSE NOT TO DUPLICATE. RATHER, WE ARE ACTIVELY PARTNERING WITH THE COUNTY TO ADDRESS THESE NEEDS IN ADDITION TO OTHER NEEDS WE IDENTIFIED AS A PART OF OUR CHNA.
REHABILITATION HOSPITAL OF WISCONSIN LLCPART V, SECTION B, LINE 14G: 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 20D: 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.
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
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.
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):$11,754,492 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 $39,523 RELATED TO REHABILITATION HOSPITAL OF WISCONSIN, LLC. BOTH AMOUNTS WERE SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE.
PART II, COMMUNITY BUILDING ACTIVITIES:WAUKESHA/OCONOMOWOC MEMORIAL HOSPITALS HAVE PARTNERSHIPS WITH VARIOUS ORGANIZATIONS THROUGHOUT THE COMMUNITIES WE SERVE. ONE EXAMPLE IS THE PARTNERSHIPS WE HAVE WITH THE LOCAL CHAMBERS OF COMMERCE WITHIN OUR SERVICE AREA BY PROVIDING LEADERSHIP AND HEALTH RELATED OUTREACH TOWARDS STRENGTHENING COMMUNITY DEVELOPMENT. WE ARE THE MAJOR SPONSOR FOR "LEADERSHIP WAUKESHA", A PROGRAM THAT FOCUSES ON THE DEVELOPMENT OF EMERGING LEADERS IN OUR COUNTY. ADDITIONALLY, WE PROVIDE LAND, RESOURCES AND EXPERTISE FOR LOCAL COMMUNITY GARDENS. WE PROVIDE DELIVERY OF EMERGENCY CARE IN THE COMMUNITY AND OFFER/SUPPORT NUMEROUS SERVICES AIMED AT OUR YOUTH INCLUDING SPONSORSHIP OF SAFE "AFTER PROM" ACTIVITIES. WE SUPPORT AREA HOMELESS SHELTERS AND ARE ACTIVE MEMBERS OF THE HOUSING ACTION COALITION AND HISPANIC COLLABORATIVE NETWORK.
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 COLLECTING AND ANALYZING PRIMARY DATA FOR OUR FORMAL CHNA AS REQUIRED BY THE AFFORDABLE CARE ACT.
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 1960, THE POPULATION OF THE COUNTY HAS MORE THAN DOUBLED. WAUKESHA COUNTY HAS AN AGING POPULATION WITH 14.7% OVER THE AGE OF 65 AND A MEDIAN AGE OF 42.0 YEARS. 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: CAUCASIAN (NON-HISPANIC) 94.1%, HISPANIC OR LATINO 4.4%, ASIAN 3.0%, BLACK 1.4%. MEDIAN HOUSEHOLD INCOME IS $75,689, WITH 5.0% OF PEOPLE LIVING BELOW THE POVERTY LEVEL. UNEMPLOYMENT IN WAUKESHA COUNTY STOOD AT 4.2% AS OF SEPTEMBER 2014. THE PRESENCE OF SOME HIGH INCOME COMMUNITIES IN WAUKESHA COUNTY OFTEN GIVES A MISTAKEN IMPRESSION. 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, FROM ABOUT 9,451 PEOPLE IN 2000 TO MORE THAN 30,000 IN 2011. THE HISPANIC POPULATION HAS SEEN A 42% INCREASE IN THE PAST 8 YEARS. 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.
PART VI, LINE 5:OCONOMOWOC/WAUKESHA MEMORIAL HOSPITAL HAS PARTNERSHIPS WITH VARIOUS NON-PROFIT ORGANIZATIONS AIMED AT IMPROVING THE HEALTH OF OUR COMMUNITY. WE ARE ACTIVELY INVOLVED WITH PROGRAMMING AND ONGOING FINANCIAL SUPPORT OF THE WAUKESHA COMMUNITY HEALTH CENTER, THE NEW AND ONLY FEDERALLY-QUALIFIED HEALTH CENTER SERVING OUR AREA. WE PROVIDE ONGOING FINANCIAL AND IN-KIND SUPPORT TO THE AREA FREE CLINICS. SEVERAL OF OUR STAFF ARE ACTIVITY INVOLVED WITH THE HEALTH DEPARTMENT'S CHIPP AND SERVE ON A VARIETY OF COMMITTEES FOR THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. OUR OUTREACH NURSING PROGRAM SUPPORTS MORE THAN 70 AREA PARTNER AGENCIES. FROM COMMUNITY-WIDE HEALTH FAIRS OFFERING A WIDE VARIETY OF FREE SCREENINGS TO OUR ONGOING PROVISION OF OPERATIONAL SPACE FOR THE WAUKESHA COUNTY COMMUNITY DENTAL CLINIC AND MULTIPLE OTHER NON-PROFITS, WE PROVIDE BROAD SUPPORT TO SAFETY NET ORGANIZATIONS IN OUR AREA. WE ALSO PROVIDE OTHER, DIVERSE SUPPORT IN THE COMMUNITY SUCH AS NUMEROUS SERVICES AIMED AT OUR YOUTH INCLUDING SPONSORSHIP OF SAFE "AFTER PROM" ACTIVITIES. WE SUPPORT AREA HOMELESS SHELTERS AND ARE ACTIVE MEMBERS OF THE HOUSING ACTION COALITION AND HISPANIC COLLABORATIVE NETWORK.
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. - OPERATES 18 CLINIC AND URGENT CARE LOCATIONS THROUGHOUT WAUKESHA COUNTY AND THE SURROUNDING COMMUNITIES. PROHEALTH CARE MEDICAL ASSOCIATES FULFILLS ITS EXEMPT PURPOSE BY PROVIDING CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. PROHEALTH CARE MEDICAL ASSOCIATES PROVIDED 432,729 CLINIC VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2014.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 9,038 DAYS OF INPATIENT CARE AND APPROXIMATELY 68,208 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2014.
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 INCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1N17 W24100 RIVERWOOD DR STE 200AddressLine1
CityWAUKESHACity
StateWIState
ZIP Code531881131ZIPCode
FieldValueIRS element (for citing)
Recipient EIN391486873RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Non Cash Assistance$17,933,881NonCashAssistanceAmt
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 PaymentYes (1)SeverancePaymentInd
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
SUSAN EDWARDS
CEO - PHC$0$775,024$0$185,382$0$0$0$750,007$0$18,570$0$1,728,983$0$185,382
JOHN ROBERTSTAD
PRESIDENT - PHC HOSPITAL DIVISION$444,913$0$97,684$0$1,655$0$36,671$0$34,128$0$615,051$0$97,684$0
NANINE NELSON
CFO - PHC - PART YEAR$0$327,182$0$0$0$82,929$0$11,214$0$12,131$0$433,456$0$275,124
JAMES GARDNER
VP MEDICAL AFFAIRS$355,020$0$69,194$0$12,519$0$29,909$0$29,321$0$495,963$0$60,896$0
KENNETH PRICE
CHIEF ADMIN OFFICER$139,266$117,367$47,221$0$9,243$0$23,059$0$25,110$0$243,899$117,367$47,221$0
ERIC HENDEE
CHIEF PHYSICIST - RADIOLOGY$189,627$0$6,103$0$0$0$16,282$0$25,292$0$237,304$0$398$0
MOHAMMAD KHARBAT
DIRECTOR PHARMACY$173,533$0$10,027$0$0$0$9,443$0$20,490$0$213,493$0$10,027$0
LINDA TREVINO
CLINICAL NURSE II$136,359$861$14,432$0$0$0$2,519$0$134$0$153,444$861$242$0
MICHAEL KOWALOK
PHYSICIST$172,911$0$331$0$0$0$4,603$0$9,666$0$187,511$0$331$0
JEAN MCDONALD
DIRECTOR ONCOLOGY-WOMEN'S SERVICES$147,564$0$8,554$0$0$0$1,514$0$12,963$0$170,595$0$8,554$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 5. WRITTEN EMPLOYEMENT CONTRACT
PART I, LINES 4A-BLINE 4A: NANINE NELSON RECEIVED SEVERANCE PAYMENTS TOTALING $82,929 DURING THE 2013 CALENDAR YEAR. PAYMENTS ARE MADE IN BIWEEKLY INSTALLMENTS OVER AN 18 MONTH PERIOD PER THE AGREEMENT BETWEEN NANINE NELSON AND PROHEALTH CARE, INC. LINE 4B: NAME CURRENT FISCAL YEAR PAYOUT NANINE NELSON $186,460 JAMES GARDNER KENNETH PRICE SUSAN EDWARDS PROHEALTH CARE INC. (PHC) MAINTAINS A SUPPLEMENTAL RETIREMENT PLAN (SERP) FOR A SELECT GROUP OF EXECUTIVES OF PHC AND ITS AFFILIATED ENTITIES. THE SERP IS AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION PLAN THAT IS INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THE SERP 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 (3 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
WISCONSIN HEALTH & EDUCATIONAL FACILITIES
A39133785597710BDJ82008-08-14$107,960,000CURRENT REFUND BONDS ISSUED 4/25/01 & CURRENT REFUND BONDS ISSUED 6/9/04.000
WISCONSIN HEALTH & EDUCATIONAL FACILITIES
B39133785597710BGZ92009-04-30$66,126,415RENOVATION TO HOSPITAL FACILITY & CONSTRUCTION OF PARKING STRUCTURE.000
WISCONSIN HEALTH & EDUCATIONAL FACILITIES
C39133785597710BB502011-02-16$32,039,358CURRENT REFUND BONDS ISSUED 11/14/95 & CURRENT REFUND BONDS ISSUED 5/13/99.000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndIn Reserve FundInReserveFundAmtCapital ExpendituresCapitalExpendituresAmt
A$2,083,436$108,443,475$865,989$659,057$106,918,4292007Yes (1)0Yes (1)Yes (1)
B$59,515,749$860,774201000Yes (1)Yes (1)$6,029,422$58,654,976
C$4,494,751$32,039,358$597,186$31,442,1732001Yes (1)0Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndEngage Bond Counsel ContractsEngageBondCounselContractsIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00Yes (1)Yes (1)00.000000.000000.00000000
B00Yes (1)Yes (1)00.000000.000000.00000000
C00Yes (1)Yes (1)00.000000.000000.00000000

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A00Yes (1)0Yes (1)0000
B00Yes (1)000000
C00Yes (1)000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0
C0

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, A - COL. CTHE CUSIP # OF 97710BDH2 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 $122,535,000. THE AMOUNT REPORTED ON SCHEDULE K IS ONLY THE AMOUNT OF THE ISSUE BENEFITING THE REPORTING ORGANIZATION.
PART I, B - COL. CTHE CUSIP # OF 97710BGW6 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, B - COL. ETHE TOTAL ISSUE PRICE ON FORM 8038 IS $134,951,867.50. THE AMOUNT REPORTED ON SCHEDULE K IS ONLY THE AMOUNT OF THE ISSUE BENEFITING THE REPORTING ORGANIZATION.
PART I, C - 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, C - 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 $108,443,475.00 ALLOCABLE TO REPORTING ORGANIZATION PLUS ZERO INVESTMENT PROCEEDS.
PART II, A - LINE 6PROCEEDS IN THE AMOUNT OF $106,918,428.56 ALLOCABLE TO REPORTING ORGANIZATION DEPOSITED IN REFUNDING ESCROWS ON 8/14/08; BALANCE ON 9/30/14 IS ZERO.
PART II, A - LINE 7$865,989.17 OF PROCEEDS ALLOCABLE TO REPORTING ORGANIZATION USED FOR ISSUANCE COSTS; $659,057.27 USED FOR CREDIT ENHANCEMENT.
PART II, A - LINE 13YEAR OF SUBSTANTIAL COMPLETION OF PROJECTS FINANCED WITH REFUNDED PRIOR BONDS ISSUED 4/25/01 WAS 2003 AND YEAR OF SUBSTANTIAL COMPLETION OF PROJECTS FINANCED WITH REFUNDED PRIOR BONDS ISSUED 6/09/04 WAS 2007.
PART II, B - LINE 3SALE PROCEEDS OF ISSUE IN AMOUNT OF $66,126,415.08 ALLOCABLE TO REPORTING ORGANIZATION PLUS $1,975.67 OF INVESTMENT PROCEEDS ALLOCABLE TO REPORTING ORGANIZATION LESS SALE PROCEEDS IN THE AMOUNT OF $6,612,641.51 DEPOSITED IN REASONABLY REQUIRED RESERVE FUND ALLOCABLE TO REPORTING ORGANIZATION.
PART II, C - LINE 3SALE PROCEEDS OF ISSUE IN AMOUNT OF $32,039,358 PLUS ZERO INVESTMENT PROCEEDS.
PART II, C - 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, C - 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.
SCH KIN 2012, PHC REFUNDED A PORTION OF THE 2009 BOND ISSUE, THE WMH PORTION IS INCLUDED IN THE BONDS RETIRED. ASSOCIATED WITH THE REFUNDING THE 2009 DEBT SERVICE RESERVE FUND WAS REDUCED BY $1,190,243.80 OF WHICH $583,219.46 IS WMH'S ALLOCATED REDUCTION.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
WAUKESHA HEALTH SYSTEM INC
BOARD MEMBER, JOHN ROBERTSTAD, IS AN OFFICER OF WAUKESHA HEALTH SYSTEM$894,280WAUKESHA HEALTH SYSTEM PROVIDES RENT AND REIMBURSEMENT OF EXPENSES TO WMH.0
THE ORTHOPEDIC SURGERY CENTER
BOARD MEMBER JOHN ROBERTSTAD IS AN OFFICER OF THE ORTHOPEDIC SURGERY CENTER$683,897INVESTMENT DISTRIBUTIONS0
PROHEALTH ALIGNED LLC (DBA MSC)
JOHN ROBERTSTAD AND KENNETH PRICE ARE DIRECTORS OF PROHEALTH ALIGNED$1,873,374INVESTMENT DISTRIBUTIONS0
PROHEALTH SOLUTIONS
JOHN ROBERTSTAD, SUSAN EDWARDS AND RON FARR ARE BOARD MEMBERS OF PHS$782,382PROHEALTH SOLUTIONS PROVIDES PHYSICIAN SERVICES TO WAUKESHA MEMORIAL HOSPITAL.0

Schedule N IRS990ScheduleN

Disposition Of Assets Detail DispositionOfAssetsDetail (2 entries)

Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDescDistributionDistributionDtFair Market Value Of AssetFairMarketValueOfAssetAmtMethod Of FMV DeterminationMethodOfFMVDeterminationTxtEINEINAddress Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeIRC SectionIRCSectionTxt
PROHEALTH CARE INC
INVESTMENT SECURITIES2014-08-31$55,612,882CURRENT QUOTED PRICES OF SECURITIES391786873N17 W24100 RIVERWOOD DR SUITEWAUKESHAWI53188501 (C)(3)
PROHEALTH CARE INC
INVESTMENT SECURITIES2014-09-30$298,284,819CURRENT QUOTED PRICES OF SECURITIES391786873N17 W24100 RIVERWOOD DR SUITEWAUKESHAWI53188501 (C)(3)
FieldValueIRS element (for citing)
Director Of Successor2Yes (1)DirectorOfSuccessor2Ind
Employee Of Successor20EmployeeOfSuccessor2Ind
Owner Of Successor20OwnerOfSuccessor2Ind
Receive Compensation20ReceiveCompensation2Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART II, LINE 2E:PERSON(S) INVOLVED: SUSAN EDWARDS, JOHN RAASCH, JANET SWANDBY, JIM GANNON, TOM PACKEE, DIXON BENZ, HELEN FORSTER, BETTY ARNDT, ELLEN MURPHY, RALPH RAMIREZ, DOUG HASTAD, MARK MOHR, DAVID ROELKE, AND JULIE SCHROEDER.
PART II, LINE 2E:EXPLANATION OF INVOLVEMENT: THE ABOVE INDIVIDUALS ARE DIRECTORS ON BOTH BOARDS OF WAUKESHA MEMORIAL HOSPITAL AND PROHEALTH CARE, INC.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3DAVID EBEL WAS COMPENSATED BY WARBIRD CONSULTING, A MANAGEMENT COMPANY, FOR SERVICES AS INTERIM CFO FOR WAUKESHA MEMORIAL HOSPITAL, INC. AND RELATED ORGANIZATIONS. THE COMPENSATION WAS PAID TO WARBIRD CONSULTING BY PROHEALTH CARE, INC., THE PARENT ORGANIZATION.
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 2014.
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 6,263,640. MANAGEMENT AND GENERAL EXPENSES 144,228. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,407,868. PHCMA PHYSICIAN FEE SUBSIDY: PROGRAM SERVICE EXPENSES 5,343,785. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,343,785. LINEN SERVICES: PROGRAM SERVICE EXPENSES 1,167,521. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,167,521. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 7,686,404. MANAGEMENT AND GENERAL EXPENSES 863,145. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,549,549. PHC SERVICES: PROGRAM SERVICE EXPENSES 81,258,383. MANAGEMENT AND GENERAL EXPENSES 8,928,502. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 90,186,885. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 1,202,963. MANAGEMENT AND GENERAL EXPENSES 9,384,387. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,587,350.
FORM 990, PART XI, LINE 9:CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS -211,917. CHANGE IN MINIMUM PENSION LIABILITY -9,504,439. INVESTMENT CONSIDERATION -353,897,701. OTHER CHANGES -123,188.
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/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled 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/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant 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$1,179,161$4,510,5880Yes (1)0.51000
REHABILITATION HOSPITAL OF WISCONSIN LLC
1625 COLDWATER CREEK DRIVEWAUKESHAWI53188262332250INPATIENT REHABILITATIONWIWAUKESHA MEMORIAL HOSPITAL INCRELATED$6,939,444$3,050,3800Yes (1)0.49000
THE ORTHOPEDIC SURGERY CENTER LLC
W238 N1610 BUSSE ROADWAUKESHAWI53188208356016ORTHOPEDIC SURGICAL SERVICESWIWAUKESHA MEMORIAL HOSPITAL INCRELATED$1,223,928$2,452,6580Yes (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/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary 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 (25 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
PROHEALTH CARE FOUNDATION INC
C$1,396,440ACTUAL AMOUNT RECEIVED
PROHEALTH CARE MEDICAL ASSOCIATES INC
A$1,009,336ACTUAL AMOUNT RECEIVED
REHABILITATION HOSPITAL OF WISCONSIN
A$1,190,957ACTUAL AMOUNT RECEIVED
WAUKESHA HEALTH SYSTEM INC
A$34,640ACTUAL AMOUNT RECEIVED
WAUKESHA HEALTH SYSTEM INC
K$88,500ACTUAL COSTS INCURRED
PROHEALTH CARE MEDICAL ASSOCIATES INC
K$515,137ACTUAL COSTS INCURRED
NATIONAL REGENCY OF NEW BERLIN INC
K$602,863ACTUAL COSTS INCURRED
PROHEALTH ALIGNED LLC
K$400,068ACTUAL COSTS INCURRED
PROHEALTH CARE INC
M$90,186,885ACTUAL COSTS INCURRED
PROHEALTH SOLUTIONS
M$782,382ACTUAL COSTS INCURRED
PROHEALTH ALIGNED LLC
M$84,266ACTUAL COSTS INCURRED
REHABILITATION HOSPITAL OF WISCONSIN
L$151,294ACTUAL AMOUNT RECEIVED
OCONOMOWOC MEMORIAL HOSPITAL INC
P$645,644ACTUAL COSTS INCURRED
PROHEALTH CARE MEDICAL ASSOCIATES INC
P$397,159ACTUAL COSTS INCURRED
OCONOMOWOC MEMORIAL HOSPITAL INC
Q$12,622,152ACTUAL AMOUNT RECEIVED
PROHEALTH CARE INC
Q$946,526ACTUAL AMOUNT RECEIVED
WAUKESHA HEALTH SYSTEM INC
Q$769,507ACTUAL AMOUNT RECEIVED
PROHEALTH CARE MEDICAL ASSOCIATES INC
Q$28,097,877ACTUAL AMOUNT RECEIVED
PROHEALTH HOME CARE INC
Q$1,223,779ACTUAL AMOUNT RECEIVED
EMPATHIA PACIFIC INC
Q$1,121,504ACTUAL AMOUNT RECEIVED
PROHEALTH CARE INC
B$18,037,881ACTUAL COSTS INCURRED
PROHEALTH ALIGNED LLC
S$1,388,140ACTUAL AMOUNT RECEIVED
ORTHOPEDIC SURGERY CENTER
S$681,773ACTUAL AMOUNT RECEIVED
REHABILITATION HOSPITAL OF WISCONSIN
S$979,821ACTUAL AMOUNT RECEIVED
PROHEALTH CARE INC
R$353,897,701ACTUAL COSTS INCURRED

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