LAKEVIEW MEDICAL CENTER INC OF RICE LAKE: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- LAKEVIEW MEDICAL CENTER INC OF RICE LAKE (EIN 39-0837206)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-08-13
- IRS object ID
- 201512259349301311
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-08-13T09:00:21-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 Wells Fargo Ctr 90 S 7th | AddressLine1 |
| City | Minneapolis | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390837206 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEVIEW MEDICAL CENTER INC OF RICE LAKE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JACQUELINE KLEIN | InCareOfNm |
| Business Name Control | LAKE | BusinessNameControlTxt |
| Phone | 7152341515 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 WEST STOUT STREET | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | RICE LAKE | City |
| State | WI | State |
| ZIP Code | 54868 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JACKIE KLEIN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7152341515 | PhoneNum |
| Signature | 2015-08-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Ann K Lamoureux | PreparerPersonNm |
| PTIN | P00691316 | PTIN |
| Phone | 7152341515 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEVIEW MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | EDWARD H WOLF | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 WEST STOUT STREET | AddressLine1 |
| City | RICE LAKE | City |
| State | WI | State |
| ZIP Code | 54868 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $69,291,399 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.lakeviewmedical.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1919 | FormationYr |
| Activity Or Mission | LAKEVIEW MEDICAL CENTER SERVES THE COMMUNITY BY PROVIDING SERVICES INTENDED TO ENHANCE THE HEALTH OF THE PEOPLE IN THE SURROUNDING REGION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 461 | TotalEmployeeCnt |
| Total Volunteers | 180 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $70,568 | PYContributionsGrantsAmt |
| CY Contributions Grants | $90,402 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $67,236,429 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $68,820,077 | CYProgramServiceRevenueAmt |
| PY Investment Income | $64,337 | PYInvestmentIncomeAmt |
| CY Investment Income | $180,088 | CYInvestmentIncomeAmt |
| PY Other Revenue | $123,237 | PYOtherRevenueAmt |
| CY Other Revenue | $129,015 | CYOtherRevenueAmt |
| PY Total Revenue | $67,494,571 | PYTotalRevenueAmt |
| CY Total Revenue | $69,219,582 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $30,075,244 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $28,792,034 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $30,441,089 | PYOtherExpensesAmt |
| CY Other Expenses | $30,502,800 | CYOtherExpensesAmt |
| PY Total Expenses | $60,516,333 | PYTotalExpensesAmt |
| CY Total Expenses | $59,296,834 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,978,238 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $9,922,748 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $122,242,322 | TotalAssetsBOYAmt |
| Total Assets EOY | $117,102,841 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $55,511,935 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $54,497,706 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $66,730,387 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $62,605,135 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | LAKEVIEW MEDICAL CENTER PROVIDES MEDICAL, SURGICAL, EMERGENCY, OUTPATIENT, DIALYSIS, AMBULANCE, ONCOLOGY, HOSPICE, AND HOME HEALTH SERVICES. IT ALSO SERVES THE COMMUNITY BY PROVIDING SERVICES INTENDED TO ENHANCE THE HEALTH OF THE PEOPLE IN THE SURROUNDING REGION. | MissionDesc |
| Significant New Program Srvc | Yes (true) | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $8,561,924 | ExpenseAmt |
| Revenue | $21,242,105 | RevenueAmt |
| Desc | LAKEVIEW MEDICAL CENTER PROVIDES INPATIENT AND OUTPATIENT SURGICAL SERVICES IN ORTHOPEDICS, UROLOGY, WOMEN'S HEALTH, ENT AND GENERAL SURGERY. FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2014 THERE WERE 3,620 SURGICAL CASES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,990,667 | ExpenseAmt |
| Revenue | $4,941,832 | RevenueAmt |
| Desc | LAKEVIEW MEDICAL CENTER PROVIDES ROOM, BOARD AND CARE TO MEDICAL AND SURGICAL PATIENTS. FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2014 THIS UNIT HAD 2,174 DISCHARGES AND 6,796 PATIENT DAYS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,352,347 | ExpenseAmt |
| Revenue | $10,243,460 | RevenueAmt |
| Desc | LAKEVIEW MEDICAL CENTER LABORATORY PERFORMS INPATIENT AND OUTPATIENT TESTS FOR BOTH LAKEVIEW MEDICAL CENTER AND MARSHFIELD CLINIC. FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2014 THERE WERE 279,587 TESTS PERFORMED BY THE LAB. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $31,394,946 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $2,000 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $31,910,028 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $47,299,884 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 31 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 461 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JACQUELINE KLEIN | PersonNm |
| Phone | 7152366129 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 WEST STOUT STREET | AddressLine1 |
| City | RICE LAKE | City |
| State | WI | State |
| ZIP Code | 54868 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DR BRADLEY BEKKUM | ||||||||
| CHAIRMAN | 1.0 | 56.0 | Yes (X) | Yes (X) | $0 | $333,712 | $49,149 | |
| DR PETER NEAL | ||||||||
| CHAIRMAN | 1.0 | 55.0 | Yes (X) | Yes (X) | $0 | $338,552 | $50,239 | |
| DR WILLIAM BARKLEY | ||||||||
| DIRECTOR | 1.0 | 55.0 | Yes (X) | $0 | $267,244 | $51,909 | ||
| DR LAURA NELSON | ||||||||
| DIRECTOR | 1.0 | 55.0 | Yes (X) | $0 | $380,361 | $51,233 | ||
| DR DOUGLAS REDING | ||||||||
| DIRECTOR | 1.0 | 56.0 | Yes (X) | $0 | $536,314 | $50,033 | ||
| DR DANIEL ERICKSON | ||||||||
| DIRECTOR | 1.0 | 56.0 | Yes (X) | $0 | $219,699 | $48,567 | ||
| SCOTT POLENZ | ||||||||
| DIRECTOR | 1.0 | 55.0 | Yes (X) | $0 | $197,026 | $49,424 | ||
| JAMES DORRANCE | ||||||||
| VICE CHAIRMAN | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAVID HILLEBRAND | ||||||||
| SECRETARY | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| CAROL HAKALA | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| CRAIG FOWLER | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| PAUL CHASE | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| SUE TINDELL | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| SANDY BONNEVILLE | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| TRACY WHITE | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DR MARK NYMO | ||||||||
| DIRECTOR | 1.0 | 55.0 | Yes (X) | $0 | $154,537 | $37,446 | ||
| EDWARD WOLF | ||||||||
| CHIEF ADMINISTRATIVE OFFICER | 55.0 | 0.0 | Yes (X) | $264,765 | $0 | $49,580 | ||
| CYNTHIA ARTS-STRENKE | ||||||||
| CHIEF OPERATING OFFICER | 55.0 | 0.0 | Yes (X) | $180,122 | $0 | $46,743 | ||
| JACQUELINE KLEIN | ||||||||
| CHIEF FINANCIAL OFFICER | 55.0 | 0.0 | Yes (X) | $160,464 | $0 | $45,956 | ||
| KATE HILLYER | ||||||||
| PHARMACY MANAGER | 55.0 | 0.0 | $129,805 | $0 | $22,930 | Yes (X) | ||
| ANNA ROGALLA | ||||||||
| PHARMACIST | 55.0 | 0.0 | $116,379 | $0 | $36,664 | Yes (X) | ||
| YUKIKO DENNIS | ||||||||
| PHARMACIST | 55.0 | 0.0 | $116,792 | $0 | $32,328 | Yes (X) | ||
| TYLER GEERDES | ||||||||
| PHARMACIST | 55.0 | 0.0 | $112,898 | $0 | $14,390 | Yes (X) | ||
| SHERRY JOHNSON | ||||||||
| NURSE MANAGER | 55.0 | 0.0 | $114,932 | $0 | $16,808 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,196,157 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,427,445 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $653,399 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Cerner Corporation | |||||
| PO Box 412702 | KANSAS CITY | MO | 64141 | Computer Consulting | $2,181,690 |
| Aramark Corporation | |||||
| 24863 Network Place | CHICAGO | IL | 606731248 | Management Services | $377,989 |
| Sightpath Medical LLC | |||||
| PO Box 204253 | DALLAS | TX | 753204253 | Medical Services | $299,889 |
| SPM Marketing Comm | |||||
| 15 W Harris Ste 300 | LA GRANGRE | IL | 60525 | Marketing Services | $293,883 |
| RX Consultants | |||||
| 105 Western Avenue | WAUPACA | WI | 54981 | Management Services | $169,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $4,500 | FederatedCampaignsAmt |
| Fundraising | $14,281 | FundraisingAmt |
| Government Grants | $18,079 | GovernmentGrantsAmt |
| All Other Contributions | $53,542 | AllOtherContributionsAmt |
| Total Contributions | $90,402 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 624100 | $66,542,769 | $66,542,769 | |
| LEASING REVENUE | 624100 | $1,523,838 | $1,523,838 | |
| LIFELINE PROGRAM | 624100 | $136,593 | $136,593 | |
| OCCUPATIONAL/INDUSTRIAL HEALTH | 624100 | $29,306 | $29,306 | |
| EMPLOYEE MEALS | 624100 | $337,668 | $337,668 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $249,903 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $104,919 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $144,984 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $68,820,077 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $197,341 | TotalRevenueColumnAmt |
| Exclusion | $197,341 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $132,281 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $132,281 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $132,281 | TotalRevenueColumnAmt |
| Exclusion | $132,281 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $37,700 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $54,953 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$17,253 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$17,253 | TotalRevenueColumnAmt |
| Exclusion | -$17,253 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rpt Fundraising Event | $14,281 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $16,778 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$16,778 | TotalRevenueColumnAmt |
| Exclusion | -$16,778 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $13,598 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $86 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,512 | TotalRevenueColumnAmt |
| Exclusion | $13,512 | ExclusionAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $69,219,582 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $68,337,425 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $791,755 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,000 | TotalAmt |
| Program Services | $2,000 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $769,874 | TotalAmt |
| Management And General | $769,874 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,370,646 | TotalAmt |
| Program Services | $18,162,453 | ProgramServicesAmt |
| Management And General | $2,208,193 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,995,112 | TotalAmt |
| Program Services | $1,777,051 | ProgramServicesAmt |
| Management And General | $218,061 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,176,784 | TotalAmt |
| Program Services | $3,549,376 | ProgramServicesAmt |
| Management And General | $627,408 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,479,618 | TotalAmt |
| Program Services | $1,317,573 | ProgramServicesAmt |
| Management And General | $162,045 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $360,255 | TotalAmt |
| Program Services | $360,255 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,355 | TotalAmt |
| Management And General | $194,355 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,120 | TotalAmt |
| Management And General | $170,120 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,334,145 | TotalAmt |
| Program Services | $2,616,591 | ProgramServicesAmt |
| Management And General | $2,717,554 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,864 | TotalAmt |
| Management And General | $129,864 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,971,764 | TotalAmt |
| Program Services | $9,582,669 | ProgramServicesAmt |
| Management And General | $389,095 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,986,007 | TotalAmt |
| Program Services | $159,148 | ProgramServicesAmt |
| Management And General | $1,826,859 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,635,408 | TotalAmt |
| Program Services | $1,297,964 | ProgramServicesAmt |
| Management And General | $2,337,444 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,726 | TotalAmt |
| Program Services | $136,726 | ProgramServicesAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,318,644 | TotalAmt |
| Program Services | $1,318,644 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,450,004 | TotalAmt |
| Program Services | $6,450,004 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $156,895 | TotalAmt |
| Management And General | $156,895 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| FOOD AND PROVISIONS | $482,947 | $482,947 | |
| DUES AND SUBSCRIPTIONS | $175,666 | $86,483 | $89,183 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,296,834 | TotalAmt |
| Program Services | $47,299,884 | ProgramServicesAmt |
| Management And General | $11,996,950 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,310 | BOYAmt |
| EOY | $2,310 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,994,930 | BOYAmt |
| EOY | $22,940,991 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,258,131 | BOYAmt |
| EOY | $12,433,492 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $627,064 | BOYAmt |
| EOY | $1,105,069 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $247,248 | BOYAmt |
| EOY | $279,475 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $112,737,990 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $35,769,488 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,090,748 | BOYAmt |
| EOY | $76,968,502 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,559 | BOYAmt |
| EOY | $12,334 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,001,332 | BOYAmt |
| EOY | $3,360,668 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,242,322 | BOYAmt |
| EOY | $117,102,841 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,884,948 | BOYAmt |
| EOY | $3,649,031 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,562,934 | BOYAmt |
| EOY | $50,285,764 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,064,053 | BOYAmt |
| EOY | $562,912 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,511,935 | BOYAmt |
| EOY | $54,497,706 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,730,387 | BOYAmt |
| EOY | $62,605,135 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,730,387 | BOYAmt |
| EOY | $62,605,135 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,242,322 | BOYAmt |
| EOY | $117,102,841 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $9,922,748 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$14,048,000 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $5,255,531 | OtherCostOrOtherBasisAmt |
| Book Value | $5,255,531 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $70,573,874 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,419,793 | DepreciationAmt |
| Book Value | $57,154,081 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $33,805,096 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,303,658 | DepreciationAmt |
| Book Value | $12,501,438 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $3,103,489 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,046,037 | DepreciationAmt |
| Book Value | $2,057,452 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $76,968,502 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED COMPENSATION | Desc |
| Amt | $562,912 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $562,912 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FASB ASC 740 Footnote: | FormAndLineReferenceDesc |
| Explanation | LAKEVIEW MEDICAL CENTER INC. OF RICE LAKE IS A NOT-FOR-PROFIT CORPORATION, AS DESCRIBED IN SECTION 501(C)(3) AND IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THIS ORGANIZATION IS, HOWEVER, SUBJECT TO FEDERAL AND STATE INCOME TAXES ON ANY NET UNRELATED BUSINESS INCOME UNDER THE PROVISIONS OF SECTION 511 OF THE CODE. THE CENTER APPLIES FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES (ASC 740), WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A MORE-LIKELY THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX PROVISION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC 740, TAX POSITIONS WILL BE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND WILL PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. BASED ON AN ANALYSIS BY THE CENTER, IT WAS DETERMINED THAT THE APPLICATION OF ASC 740 HAD NO MATERIAL EFFECT ON THE CENTER AT SEPTEMBER 30, 2014 OR 2013. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | false | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $485,202 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $485,202 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00820 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,583,014 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,283,097 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,299,917 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03880 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,068,216 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,283,097 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,785,119 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04700 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $291,032 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,578 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $267,454 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00450 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,178 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,178 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,435,604 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,900,257 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $535,347 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00900 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,172 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $27,172 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,757,986 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,923,835 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $834,151 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01410 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,826,202 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,206,932 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,619,270 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06110 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $556 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $556 | NetCommunityBenefitExpnsAmt |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,364 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,364 | NetCommunityBenefitExpnsAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,920 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,920 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,144,000 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $346,000 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $15,848,544 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $19,335,189 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$3,486,645 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | false | 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 | LAKEVIEW MEDICAL CENTER INC OF RICE L | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 WEST STOUT STREET | AddressLine1 |
| City | RICE LAKE | City |
| State | WI | State |
| ZIP Code | 54868 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | General Med & Surgical, along with ER-24 hours | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEVIEW MEDICAL CENTER INC OF RICE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (true) | 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 | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://www.lakeviewmedical.com | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | false | FPGUsedDetermEligDscntCareInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| State Regulation | Yes (X) | StateRegulationInd |
| Other Factors | Yes (X) | OtherFactorsInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | LAKEVIEW MEDICAL CENTER, INC. OF RICE LAKE USES THE FEDERAL POVERTY GUIDELINES AT 200% TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE AS STATED IN LINE 3A. FOR SELF-PAY INDIVIDUALS WHO DON'T QUALIFY FOR FREE CARE PER OUR POLICY, WE OFFER A 12% DISCOUNT (OUR HIGHEST COMMERCIAL DISCOUNT). WE ALSO OFFER AN INTEREST FREE PAYMENT PLAN, WITH THE APPROVAL OF THE CREDIT SUPERVISOR BASED ON THE PATIENT'S CIRCUMSTANCES AND ABILITY TO PAY. THE GUIDELINES FOR THE PAYMENT PLAN INCLUDE: MAXIMUM OF 60 MONTHS, LEVEL PAYMENTS OR A FRONT-END-LOADED ARRANGEMENT (I.E., LOWER INITIAL PAYMENTS WITH A BALLOON PAYMENT IS NOT ACCEPTABLE) AND A MINIMUM OF $25 PER MONTH (I.E., $5 PER MONTH ON A $25 BALANCE IS NOT APPROPRIATE). |
| 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 HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUES. 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. |
| PART II: | COMMUNITY BUILDING ACTIVITIES PROMOTING THE HEALTH IN THE COMMUNITIES SERVED: LAKEVIEW MEDICAL CENTER PARTNERED WITH BARRON COUNTY PUBLIC HEALTH, ALONG WITH THE COUNTY'S TWO OTHER HEALTHCARE SYSTEMS IN THE BARRON COUNTY COMMUNITY HEALTH IMPROVEMENT PROCESS TO IDENTIFY LOCAL HEALTH CONCERNS AND ADDRESS LOCAL HEALTH PRIORITIES LINKED TO STATE AND NATIONAL PRIORITIES. THE INFORMATION GATHERED FROM THIS PROCESS WAS USED TO IDENTIFY AND PRIORITIZE COMMUNITY HEALTH ISSUES AND NEEDS. LAKEVIEW MEDICAL CENTER HAS FOCUSED ON EDUCATION EFFORTS THROUGH HEALTH FAIRS, HEALTH EVENTS, AND COMMUNITY SCREENINGS IN THE COMMUNITY BASED ON THIS INFORMATION. LAKEVIEW MEDICAL CENTER'S SPECIFIC EFFORTS HAVE PROVIDED PROGRAMS TO STRENGTHEN "BE WELL BARRON COUNTY" WHICH IS AN INITIATIVE TO INCREASE PHYSICAL ACTIVITY AND DECREASE OBESITY RATES OF BARRON COUNTY RESIDENTS. LAKEVIEW MEDICAL CENTER IS THE LEAD ORGANIZATION AND PARTNERS CLOSELY WITH "BE WELL BARRON COUNTY" IN A WORKSITE WELLNESS PROGRAM ENTITLED "EXCEL WITH BE WELL". OUR GOAL IS TO ENGAGE WORKSITE LEADERS TO ADOPT BEST WELLNESS PRACTICES AT THEIR WORKSITES. LAKEVIEW MEDICAL CENTER COORDINATES MEETINGS SIX TIMES A YEAR AND PROVIDES RESOURCES AND PRESENTERS BASED ON THE GROUP'S INTERESTS AND NEEDS. MEETINGSAVERAGE ABOUT 40 WORKSITE LEADERS FROM A VAST ARRAY OF WORKFORCES AND SIZES. LAKEVIEW MEDICAL CENTER COORDINATED WITH WORKSITES WITH OUR WEIGHT LOSS PROGRAMS THROUGHOUT THE YEAR WITH OVER 20 WORKSITES WHOM HAVE PARTICIPATED. THE "NOT ON TOBACCO" (NOT) PROGRAM LAKEVIEW SPONSORS, IS TO SUPPLY INFORMATION TO HELP KIDS ALREADY USING TOBACCO TO QUIT. |
| PART III, LINE 4: | 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 AN ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE ORGANIZATION HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. A NUMBER OF PATIENTS ARE TRULY UNABLE TO PAY THEIR OUT-OF-POCKET LIABILITY, BUT DO NOT COMPLETE THE PROCESS REQUIRED TO APPLY FOR FINANCIAL ASSISTANCE UNDER LAKEVIEW'S CHARITY CARE POLICY EVEN THOUGH LAKEVIEW PROVIDES THIS INFORMATION TO THEM AND ASSISTANCE WITH THE APPLICATION. WITHOUT A COMPLETED APPLICATION THEY ARE TRANSFERRED TO COLLECTION SERVICES AND TREATED AS BAD DEBT EXPENSE. THESE PATIENTS WOULD QUALIFY FOR CHARITY CARE IF THEY COMPLETED THE CHARITY APPLICATION, SO THE BAD DEBT EXPENSE ASSOCIATED WITH THEM SHOULD BE ATTRIBUTABLE TO CHARITY CARE AND A COMMUNITY BENEFIT. |
| PART III, LINE 8: | THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE LAB AND THERAPY SERVICES REIMBURSED ON FEE SCHEDULES AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. THE COSTING METHOD USED FOR IRS COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED SEPTEMBER 30,2014, AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES, AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (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 ORGANIZATION'S COLLECTION AND CHARITY CARE POLICIES, LAKEVIEW MEDICAL CENTER, INC. OF RICE LAKE, MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE ORGANIZATION'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 HOSPITAL'S PATIENT FINANCIAL COUNSELOR OR SOCIAL WORKERS TO ALLOW THESE PATIENTS THE ABILITY TO GET ASSISTANCE WITH THEIR APPLICATION DURING THEIR STAY AT THE HOSPITAL. DEPENDING UPON THE PATIENT'S CONDITION, THE PATIENT OR 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 HOSPITAL'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. THE ORGANIZATION ALSO PUBLISHES INFORMATION REGARDING ITS CHARITY CARE PROGRAM ON ITS WEBSITE. A DESCRIPTION OF THE CHARITY CARE PROGRAM IS INCLUDED IN THE "WELCOME" BOOKLET THAT PATIENTS RECEIVE UPON ADMISSION. A CHARITY CARE INFORMATIONAL BROCHURE IS GIVEN TO SELF-PAY PATIENTS DURING THE REGISTRATION PROCESS AND MADE AVAILABLE TO ALL PATIENTS. |
| PART V, LINE 3: | LAKEVIEW MEDICAL CENTER PARTNERED WITH STAFF FROM THE WI WESTERN REGION OFFICE OF PUBLIC HEALTH, COUNTY PUBLIC HEALTH OFFICIALS, AND OTHER LOCAL HEALTH CARE PROVIDERS TO LEAD THE ASSESSMENT PROCESS. DIRECT COMMUNITY INPUT WAS GATHERED THROUGH A SURVEY DISTRIBUTED TO LIBRARIES, HOSPITALS, CLINICS, THE FREE CLINIC, FOOD PANTRIES, SENIOR CENTERS AND COMMUNITY CENTERS SERVING THE LOCAL MEXICAN AND SOMALI POPULATIONS. THE SURVEY WAS TRANSLATED INTO BOTH THE SPANISH AND SOMALI LANGUAGES TO ENSURE THE OPINIONS OF THOSE POPULATIONS WERE INCLUDED. |
| PART V, LINE 4: | MAYO CLINIC HEALTH SYSTEM MARSHFIELD CLINIC HEALTH SYSTEM BARRON COUNTY PUBLIC HEALTH DEPARTMENT WI DEPARTMENT OF HEALTH CUMBERLAND CLINIC AND HOSPITAL |
| PART V, LINE 7: | THE TOP PRIORITIES FOR BARRON COUNTY DETERMINED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT WERE: " ALCOHOL AND DRUGS " MENTAL HEALTH " CHRONIC DISEASE LMC COMPLETED A COMMUNITY HEALTH IMPLEMENTATION PLAN INCLUDING PERFORMANCE MEASURES, OBJECTIVES, STRATEGIES AND ACTION PLANS FOR THE ALCOHOL AND DRUGS AND CHRONIC DISEASE PRIORITIES. MENTAL HEALTH WAS IDENTIFIED AS A PRIORITY, BUT LMC DOES NOT HAVE THE DEDICATED RESOURCES IN PLACE TO SUPPORT THIS ISSUE INDEPENDENTLY. |
| PART V, LINE 10: | LAKEVIEW MEDICAL CENTER, INC. OF RICE LAKE USES THE FEDERAL POVERTY GUIDELINES AT 200% TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE AS STATED IN LINE 3A. FOR SELF-PAY INDIVIDUALS WHO DON'T QUALIFY FOR FREE CARE PER OUR POLICY, WE OFFER A 12% DISCOUNT (OUR HIGHEST COMMERCIAL DISCOUNT). WE ALSO OFFER AN INTEREST FREE PAYMENT PLAN, WITH THE APPROVAL OF THE CREDIT SUPERVISOR BASED ON THE PATIENT'S CIRCUMSTANCES AND ABILITY TO PAY. THE GUIDELINES FOR THE PAYMENT PLAN INCLUDE: MAXIMUM OF 60 MONTHS, LEVEL PAYMENTS OR A FRONT-END-LOADED ARRANGEMENT (I.E., LOWER INITIAL PAYMENTS WITH A BALLOON PAYMENT IS NOT ACCEPTABLE) AND A MINIMUM OF $25 PER MONTH (I.E., $5 PER MONTH ON A $25 BALANCE IS NOT APPROPRIATE). |
| PART VI, #2: | NEEDS ASSESSMENT: LAKEVIEW MEDICAL CENTER, INC. OF RICE LAKE CONTINUES TO MOVE FORWARD WITH ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. THE CHNA WAS COMPLETED IN PARTNERSHIP WITH THE BARRON COUNTY HEALTH DEPARTMENT, AND THE FOLLOWING ORGANIZATIONS: WISCONSIN DEPARTMENT OF HEALTH, MARSHFIELD CLINIC, MARSHFIELD CLINIC DENTAL CENTER, MAYO CLINIC HEALTH SYSTEMS, AND THE CUMBERLAND CLINIC AND HOSPITAL. THE COMMITTEE HAS IDENTIFIED A NAME FOR THE INITIATIVE, THRIVE BARRON COUNTY (THRIVE BC), GROWING TOGETHER IN HEALTH. THE CHNA WAS REVIEWED BY ITS RICE LAKE BOARD OF DIRECTORS AND SUBSEQUENTLY PUBLISHED ON ITS WEBSITE IN FEBRUARY 2013 MAKING IT WIDELY AVAILABLE TO THE COMMUNITY. HARD COPIES WERE AVAILABLE TO ANYONE REQUESTING A PRINTED VERSION. UPON COMPLETION OF THE CHNA, LMC COMPLETED A COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP) ALIGNED WITH THE 3 PRIORITIES IDENTIFIED IN THE CHNA, ALCOHOL AND OTHER DRUGS, CHRONIC DISEASE MANAGEMENT AND MENTAL HEALTH. THE CHIP INCLUDES PERFORMANCE MEASURES, OBJECTIVES, STRATEGIES AND ACTION PLANS FOR THE PRIORITIES OF CHRONIC DISEASE PREVENTION AND ALCOHOL AND OTHER DRUGS. MENTAL HEALTH WAS ALSO IDENTIFIED AS A PRIORITY IN THE CHNA, BUT UNLIKE THE OTHER TWO PRIORITY AREAS, LMC DOES NOT HAVE ANY RESOURCES IN PLACE TO SUPPORT THIS ISSUE INDEPENDENTLY. THE RICE LAKE BOARD OF DIRECTORS APPROVED THE CHIP AT THEIR SEPTEMBER 29, 2013 BOARD MEETING. AS A STRATEGY OF LAKEVIEW MEDICAL CENTER'S CHIPP PLAN RELATED TO CHRONIC DISEASE, LMC ALONG WITH THRIVE BC PARTNERS OFFERED A FREE SCREENING FOR COMMUNITY MEMBERS TO HELP IDENTIFY THOSE AT RISK OF DIABETES AND TO BEGIN TO EDUCATE THEM ON WHAT THEIR NUMBERS REALLY MEAN. LAKEVIEW MEDICAL CENTER CONDUCTED 150 FREE SCREENINGS AND COLLECTIVELY 650 WERE COMPLETED IN BARRON COUNTY. OF THE 650 PEOPLE SCREENED 33% WERE FOUND TO BE AT RISK FOR DEVELOPING DIABETES. EDUCATION WAS OFFERED TO THOSE WHO WERE FOUND TO BE AT RISK. ALSO, IN SUPPORT OF THE LAKEVIEW MEDICAL CENTER CHIPP, THE HOSPITAL PARTNERED WITH THE BARRON COUNTY SHERIFF'S DEPARTMENT ON AN UNMET COMMUNITY NEED REGARDING ALCOHOL AND OTHER DRUGS. LAKEVIEW MEDICAL CENTER PURCHASED A $19,000 DISTRACTED DRIVING SIMULATOR FOR THE DEPARTMENT. THE SHERIFF'S DEPARTMENT WILL TAKE THE SIMULATOR TO LOCAL SCHOOLS, FAIRS, FESTIVALS, ETC. FOR THE PUBLIC TO EXPERIENCE THE EFFECTS OF TEXTING WHILE DRIVING AND DRIVING UNDER THE INFLUENCE IN AN INTERACTIVE WAY. LAKEVIEW MEDICAL CENTER, INC. OF RICE LAKE ASSESSES THE HEALTH CARE 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. IN 2012 LAKEVIEW MEDICAL CENTER JOINED WITH BARRON COUNTY IN THE BARRON COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO COLLECTIVELY IDENTIFY LOCAL HEALTH CONCERNS AND ADDRESS LOCAL HEALTH PRIORITIES LINKED TO STATE AND NATIONAL PRIORITIES. PARTNERS TO JOIN LAKEVIEW MEDICAL CENTER AND BARRON COUNTY PUBLIC HEALTH IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND CHIP PROCESS' ARE THE FOLLOWING ORGANIZATIONS: WISCONSIN DEPARTMENT OF HEALTH, MARSHFIELD CLINIC, MARSHFIELD CLINIC DENTAL CENTER, MAYO CLINIC HEALTH SYSTEMS, AND THE CUMBERLAND CLINIC AND HOSPITAL. OUR STEERING COMMITTEE MEMBERS HAVE SHOWN COMMITMENT DEDICATING FOUR HOURS PER MONTH TO MEET AND STRENGTHEN OUR PARTNERSHIPS AND DEVELOP A PLAN TO IMPROVE THE HEALTH OF BARRON COUNTY RESIDENTS. THE COMMITTEE HAS IDENTIFIED A NAME FOR THE INITIATIVE, THRIVE BARRON COUNTY (THRIVE BC), GROWING TOGETHER IN HEALTH. OUR MISSION: THRIVE BC WILL WORK TO ENGAGE COMMUNITY MEMBERS AND ORGANIZATIONS TO FOCUS RESOURCES AND DEVELOP AND STRENGTHEN PARTNERSHIPS TO ESTABLISH SUSTAINABLE, SAFE AND HEALTHY COMMUNITIES. OUR VISION: COMMUNITY MEMBERS AND ORGANIZATIONS WORKING TOGETHER TO IMPROVE THE QUALITY OF LIFE FOR EVERYONE IN BARRON COUNTY. TO MEET OUR VISION WE WILL MEET REGULARLY AND SYSTEMATICALLY COLLECT, ASSEMBLE, ANALYZE, AND MAKE AVAILABLE INFORMATION ON THE HEALTH OF THE COMMUNITY. OUR COALITION HAS COLLECTED SECONDARY DATA THROUGH BOTH AN ONLINE AND PAPER SURVEY CONCERNING DISEASE, DEATH, DISABILITY, INJURY AND COMMUNITY OPINIONS. THE SURVEY WAS TRANSLATED TO SOMALIAN AND SPANISH TO INCLUDE FEEDBACK FROM UNDERSERVED POPULATIONS IN THE COUNTY. ONE THOUSAND ONE HUNDRED AND THIRTEEN RESPONSES OUT OF THE COUNTY POPULATION OF 45,850 WERE COMPLETED. ALONG WITH THE SECONDARY DATA, THE COMMITTEE IS ANALYZING STATE AND NATIONAL DATA BASED ON THE 12 WISCONSIN HEALTH PRIORITIES. THIS DATA WAS PRESENTED TO COMMUNITY MEMBERS, LEADERS AND EXPERTS AT A SEPTEMBER 26, 2012 MEETING WHERE ATTENDEES SELECTED THE TOP THREE HEALTH PRIORITIES FOR BARRON COUNTY WHICH ARE: 1) ALCOHOL AND OTHER DRUGS; 2) MENTAL HEALTH; AND 3) CHRONIC DISEASE. THE RICE LAKE BOARD OF DIRECTORS HAS BEEN IDENTIFIED AS THE OVERSIGHT COMMITTEE THAT WILL OVERSEE THE HOSPITAL'S COMMUNITY HEALTH IMPLEMENTATION PLAN. LAKEVIEW MEDICAL CENTER HAS REPRESENTATIVES ACTIVELY WORKING ON THE THRIVE COMMITTEES FOCUSED ON ALCOHOL AND OTHER DRUGS. THE HOSPITAL ALSO HAS REPRESENTATIVES SERVING ON THE THRIVE STEERING COMMITTEE. |
| PART VI, #3: | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: UNINSURED AND UNDER INSURED PATIENTS ARE ASKED TO TALK WITH THE HOSPITAL'S PATIENT FINANCIAL COUNSELOR EITHER AT THE TIME SERVICE IS PROVIDED OR WHEN THE PATIENT'S BILL IS GENERATED. THE FINANCIAL COUSELOR EXPLAINS THE VARIOUS PAYMENT OPTIONS AVAILABLE TO THE PATIENT AS WELL AS THE HOSPITAL'S CHARITY CARE PROGRAM AND OFFERS THE CHARITY CARE APPLICATION WHEN APPROPRIATE. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE WISCONSIN MEDICAL ASSISTANCE OR BADGERCARE PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE. |
| PART VI, #4: | COMMUNITY INFORMATION: THE PRIMARY SERVICE AREA FOR LAKEVIEW MEDICAL CENTER ENCOMPASSES ALL PERSONS LIVING WITHIN A 30 TO 40 MILE RADIUS OF THE HOSPITAL. SOME OF THE COMMUNITIES INCLUDED IN THIS AREA ARE RICE LAKE, CAMERON, BARRON, BIRCHWOOD, LADYSMITH, CUMBERLAND, CHETEK, AND SPOONER, WISCONSIN, AMONG MANY OTHERS. THE HOSPITAL PROVIDES A SIGNIFICANT PORTION OF ITS PATIENT SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAL ASSISTANCE PROGRAMS, THESE MEDICARE AND MEDICAL ASSISTANCE PATIENTS ACCOUNTED FOR APPROXIMATELY 64% OF HOSPITAL'S GROSS PATIENT SERVICE REVENUE FOR THE YEAR. OTHER INFORMATION: LAKEVIEW MEDICAL CENTER, INC. OF RICE LAKE PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. IN ADDITION, THE ORGANIZATION BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. LAKEVIEW MEDICAL CENTER, 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 HOSPITAL PROVIDES LOCAL ACCESS TO MANY SERVICES INCLUDING: BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES, HOSPICE, HOME CARE, DIALYSIS, INFUSION SERVICES, HEALTH AND WELLNESS SERVICES, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SLEEP CENTER, SPEECH PATHOLOGY, SURGICAL SERVICES AND WOMENS' SERVICES, TO NAME SOME OF THE MAJOR SERVICES PROVIDED. LAKEVIEW MEDICAL CENTER IS GOVERNED BY AN ELEVEN MEMBER BOARD OF DIRECTORS, INCLUDING SIX COMMUNITY MEMBERS. |
| PART VI, #5: | RICE LAKE FREE CLINIC: THE HOSPITAL OFFERS FREE RADIOLOGY AND LAB SERVICES TO THE FREE CLINIC SERVING THE UNDERSERVED POPULATION IN THE AREA. HEALTH AND WELLNESS CENTER THE HEALTH AND WELLNESS CENTER IS THE ONLY ONE IN THE AREA OFFERING COMMUNITY MEMBERS THE OPPORTUNITY TO EXERCISE WHILE BEING SUPERVISED BY MEDICALLY TRAINED STAFF. RADIOLOGY STUDENT EDUCATION AND WITC NURSING ORIENTATION LAKEVIEW MEDICAL CENTER IS COMMITTED TO SUPPORT THE TRAINING OF FUTURE MEDICAL PROFESSIONALS TO IMPACT PROJECTED MEDICAL STAFF SHORTFALLS. HANG ON CHALLENGE ANOTHER LAKEVIEW MEDICAL CENTER INITIATIVE TO ADDRESS HEALTH RISKS RELATED TO CHRONIC DISEASE IS OUR HANG ON CHALLENGE. THIS IS A COMMUNITY CHALLENGE TO ASSIST COMMUNITY MEMBERS TO LOSE OR MAINTAIN THEIR WEIGHT DURING THE HOLIDAY SEASON. 330 PARTICIPANTS WERE ABLE TO LOSE A TOTAL OF 345 POUNDS DURING THIS 8-WEEK CHALLENGE. LMC HEALTH PROMOTION STAFF PROVIDED PARTICIPANTS WITH WEEKLY NUTRITION AND EXERCISE EDUCATION HAND-OUTS. WALK WITH A DOC THIS PROGRAM WAS A NEW INITIATIVE AND WAS ATTENDED BY 200 COMMUNITY PARTICIPANTS. LOCAL PHYSICIANS AND THEIR FAMILIES WALKED THE COMMUNITY WALKING TRAIL AND PROVIDED EDUCATION IN A COMMUNITY SETTING. LAKEVIEW MEDICAL CENTER PARTNERED WITH LOCAL BUSINESSES AND PROVIDED ATTENDEES WITH A HEALTHY LUNCH AND PRIZES. THIS INITIATIVE WAS DESIGNED TO ADDRESS OUR COMMUNITY'S NEED FOR PHYSICAL ACTIVITY. WEIGHT LOSS CHALLENGE IN LIGHT OF RISING OBESITY ISSUES IN THE COUNTY THIS PROGRAM WAS DEVELOPED. THERE WERE 500 PARTICIPANTS FROM 20 AREA BUSINESSES AND THE COMMUNITY WHO LOST A TOTAL OF 4,000 POUNDS DURING THIS 12- WEEK CHALLENGE. THROUGHOUT THE 12 WEEKS, FITNESS CLASSES AND NUTRITIONAL EDUCATION WAS OFFERED FREE OF CHARGE OR AT A NOMINAL FEE. FARMER'S MARKET LMC HAS A BOOTH AT A LOCAL FARMER'S MARKET THAT HAS 200-300 ATTENDEES EACH WEEK. THE HOSPITAL OFFERS A DIFFERENT HEALTH RELATED TOPIC/SCREENING EACH WEEK. LMC HAS ADMINISTERED 250 FREE BLOOD PRESSURES AND 40 FLU SHOTS AMONG OTHER ACTIVITIES OVER THE 18 WEEKS. A FOCUS THIS YEAR WAS EDUCATING AND PROMOTING HEALTHY EATING BEHAVIORS BY PROVIDING HEALTHY SAMPLES OF FOODS THAT WERE SEASONALLY AVAILABLE AT THE MARKET |
| PART VI, #6: | AFFILIATED HEALTH CARE SYSTEM ROLES: MARSHFIELD CLINIC IS THE SOLE CORPORATE MEMBER OF LAKEVIEW MEDICAL CENTER. MARSHFIELD CLINIC IS A MULTI-SPECIALTY PHYSICIAN AND HEALTHCARE ORGANIZATION COMPRISED OF OVER 40 SITES, INCLUDING A SITE IN RICE LAKE, WISCONSIN, THE INTEGRATION OF LAKEVIEW MEDICAL CENTER AND MARSHFIELD CLINIC HAS ENHANCED THE ACCESS AND QUALITY OF HEALTH CARE THROUGHOUT RICE LAKE AND THE SURROUNDING COMMUNITIES WHILE ACHIEVING ECONOMIC EFFICIENCIES. |
| PART VI, #7: | ALL STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT: WI COMMUNITY BUILDING ACTIVITIES: THE SEXUAL ASSAULT NURSE EXAMINER (SANE) PROGRAM: THE SANE PROGRAM AT LAKEVIEW MEDICAL CENTER SUPPORTS COMMUNITY EFFORTS TO ADDRESS THE CRIME OF SEXUAL ASSAULT BY ESTABLISHING A PROCESS FOR ACCURATE EVIDENCE COLLECTION AND SUPPORT FOR SEXUAL ASSAULT SURVIVORS. NOT ON TOBACCO (NOT) PROGRAM: LAKEVIEW MEDICAL CENTER JOINED THE SAFE AND STABLE FAMILY COALITION AND LED THE EFFORT TO SECURE A GRANT FROM THE RICE LAKE AREA HEALTH FOUNDATION TO REDUCE THE TOBACCO USE IN THE GREATER RICE LAKE AREA. THROUGH THE GRANT, THE NOT ON TOBACCO (NOT) PROGRAM WAS IMPLEMENTED IN BARRON HIGH SCHOOL AND THE RESTORATIVE JUSTICE PROGRAM ADOPTED THE NOT PROGRAM AS A SANCTIONED WORKSHOP FOR REHABILITATION. ALSO, DUE TO THE HIGH STATISTICS OF SMOKING DURING PREGNANCY, LAKEVIEW MEDICAL CENTER HAS IMPLEMENTED THE FIRST BREATH PROGRAM. LAKEVIEW MEDICAL CENTER HAS BEEN REWARDED MINI-GRANTS THROUGH THE SAFE AND STABLE FAMILY COALITION TO HELP INCENTIVE PARTICIPANTS IN THE PROGRAM. THE PREGNANCY HELP CENTER HAS PARTNERED WITH LAKEVIEW MEDICAL CENTER TO UTILIZE THIS FREE PROGRAM FOR THEIR CLIENTS. ANOTHER ALARMING STATISTIC SHOWS HIGH NUMBERS OF MOTHERS WHO QUIT SMOKING DURING PREGNANCY, BUT START SMOKING AFTER DELIVERY. WITH THIS HEALTH ISSUE, LAKEVIEW MEDICAL CENTER RECEIVED A GRANT TO IMPLEMENT A SMOKING CESSATION PROGRAM TARGETED TO THIS POPULATION. WORKSITE WELLNESS COMMITTEE: A WORKSITE WELLNESS COMMITTEE WAS FORMED AT LAKEVIEW MEDICAL CENTER TO SHARE BEST EVIDENCED - BASED PRACTICES FOR EMPLOYEE HEALTH IMPROVEMENTS WITH LOCAL EMPLOYERS. A COMMUNITY OUTREACH SERIES IS OFFERED WHICH BRINGS PHYSICIANS AND PATIENTS TOGETHER IN A CASUAL ENVIRONMENT TO ANSWER QUESTIONS ABOUT SPECIFIC HEALTH NEEDS. 50 PLUS: 50 PLUS IS A FREE WELLNESS EVENT FOR THOSE OVER 50. THE EVENT OFFERS A VARIETY OF HEALTH SCREENINGS, COMMUNITY RESOURCES, EDUCATIONAL PRESENTATIONS AND ENTERTAINMENT. THIS EVENT IS COORDINATED BY A COALITION OF COMMUNITY AGENCIES LED BY LAKEVIEW MEDICAL CENTER. CHAMBER MEMBER: A HOSPITAL REPRESENTATIVE IS A MEMBER OF THE RICE LAKE CHAMBER OF COMMERCE'S BUSINESS AND EDUCATION COMMITTEE FOCUSING ON IMPROVING BUSINESS OPPORTUNITIES AND EDUCATION IN RICE LAKE. UNITED WAY MEMBER: A HOSPITAL REPRESENTATIVE IS A MEMBER OF THE RICE LAKE UNITED WAY COALITION SERVING THE COMMUNITY BY ISSUING COMMUNITY IMPROVEMENT GRANTS. FARMERS MARKET: LAKEVIEW MEDICAL CENTER HAS A BOOTH AT A LOCAL FARMERS MARKET THAT HAS 200 - 300 ATTENDEES EACH WEEK. THE HOSPITAL OFFERS A DIFFERENT HEALTH RELATED TOPIC/SCREENING EACH WEEK. LAKEVIEW MEDICAL CENTER HAS ADMINISTERED 245 BLOOD PRESSURES, 30 FLU SHOTS, 18 FALL AND BALANCE TESTS, AND 2 LUNG CAPACITY TESTS AT THE BOOTH. THE LAKEVIEW MEDICAL CENTER PROMOTIONS DEPARTMENT'S INTENTION IS TO BUILD SUSTAINABLE PROGRAMS FOR OUR COMMUNITY THAT IS IN ALIGNMENT WITH ONE OF THE TOP HEALTH CONCERNS IDENTIFIED BY THE COMMUNITY HEALTH IMPROVEMENT PLANS AND PROCESSES (CHIP) OF BARRON COUNTY: OBESITY, NUTRITION AND PHYSICAL ACTIVITY. THE OUTCOMES OBTAINED WILL BE SHARED WITH LOCAL CIVIC GROUPS AND OTHER COMMUNITY ORGANIZATIONS TO SHARE THE PROGRAM'S SUCCESSES AND LAKEVIEW MEDICAL CENTER'S COMMITMENT TO THE HEALTH OF OUR COMMUNITIES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR BRADLEY BEKKUM | ||||||||||||||
| CHAIRMAN | $0 | $309,666 | $0 | $23,626 | $0 | $420 | $0 | $30,335 | $0 | $18,814 | $0 | $382,861 | $0 | $0 |
| DR PETER NEAL | ||||||||||||||
| CHAIRMAN | $0 | $335,780 | $0 | $0 | $2,772 | $0 | $30,335 | $0 | $19,903 | $0 | $388,790 | $0 | $0 | |
| DR WILLIAM BARKLEY | ||||||||||||||
| DIRECTOR | $0 | $266,278 | $0 | $0 | $0 | $966 | $0 | $30,335 | $0 | $21,574 | $0 | $319,153 | $0 | $0 |
| DR LAURA NELSON | ||||||||||||||
| DIRECTOR | $0 | $379,395 | $0 | $0 | $966 | $0 | $30,335 | $0 | $20,898 | $0 | $431,594 | $0 | $0 | |
| DR DOUGLAS REDING | ||||||||||||||
| DIRECTOR | $0 | $534,508 | $0 | $0 | $0 | $1,806 | $0 | $30,335 | $0 | $19,698 | $0 | $586,347 | $0 | $0 |
| DR DANIEL ERICKSON | ||||||||||||||
| DIRECTOR | $0 | $217,893 | $0 | $0 | $0 | $1,806 | $0 | $30,335 | $0 | $18,232 | $0 | $268,266 | $0 | $0 |
| SCOTT POLENZ | ||||||||||||||
| DIRECTOR | $0 | $196,396 | $0 | $0 | $630 | $0 | $28,919 | $0 | $20,505 | $0 | $246,450 | $0 | $0 | |
| DR MARK NYMO | ||||||||||||||
| DIRECTOR | $0 | $151,694 | $0 | $701 | $0 | $2,142 | $0 | $21,734 | $0 | $15,712 | $0 | $191,983 | $0 | $0 |
| EDWARD WOLF | ||||||||||||||
| CHIEF ADMINISTRATIVE OFFICER | $262,785 | $0 | $0 | $0 | $1,980 | $0 | $30,335 | $0 | $19,245 | $0 | $314,345 | $0 | $0 | $0 |
| CYNTHIA ARTS-STRENKE | ||||||||||||||
| CHIEF OPERATING OFFICER | $179,432 | $0 | $0 | $0 | $690 | $0 | $25,987 | $0 | $20,755 | $0 | $226,864 | $0 | $0 | $0 |
| JACQUELINE KLEIN | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $159,174 | $0 | $0 | $0 | $1,290 | $0 | $23,952 | $0 | $22,004 | $0 | $206,420 | $0 | $0 | $0 |
| KATE HILLYER | ||||||||||||||
| PHARMACY MANAGER | $129,611 | $0 | $0 | $0 | $194 | $0 | $2,556 | $0 | $20,373 | $0 | $152,734 | $0 | $0 | $0 |
| ANNA ROGALLA | ||||||||||||||
| PHARMACIST | $115,993 | $0 | $0 | $0 | $386 | $0 | $15,948 | $0 | $20,716 | $0 | $153,043 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part III, Line 2 | NEW SERVICES INCLUDE THE ONCOLOGY INFUSION DEPARTMENT STARTED ON SEPTEMBER 1, 2014 PART III, LINE 4D - OTHER PROGRAM SERVICES THE OTHER PROGRAM SERVICES OF LAKEVIEW MEDICAL CENTER INCLUDE IMAGING, WOMEN'S HEALTH, ONCOLOGY INFUSION, INPATIENT AND OUTPATIENT CARE, AND ALL INDIRECT EXPENSES ASSOCIATED WITH FURTHERING THE EXEMPT PURPOSE. |
| Supplemental Information to Form 990 | Part VI, Section A, Line 6 MARSHFIELD CLINIC IS THE SOLE CORPORATE MEMBER OF LAKEVIEW MEDICAL CENTER. PART VI, SECTION A, LINE 7A MARSHFIELD CLINIC IS THE SOLE CORPORATE MEMBER OF LAKEVIEW MEDICAL CENTER AND HAS THE AUTHORITY TO ELECT BOARD MEMBERS. PART VI, SECTION A, LINE 7B MARSHFIELD CLINIC IS THE SOLE CORPORATE MEMBER OF LAKEVIEW MEDICAL CENTER AND THE DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF MARSHFIELD CLINIC. PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE FINANCE DEPARTMENT, THEN REVIEWED BY KPMG LLP. THE COMPLETED 990, INCLUDING REQUIRED SCHEDULES IS EMAILED TO AND REVIEWED BY THE BOARD MEMBERS BEFORE FILING. PART VI, SECTION B, LINE 12 ON AN ANNUAL BASIS, BOARD MEMBERS, TOP MANAGEMENT, AND EMPLOYEES WHO HAVE CONTACT WITH SUPPLIERS SIGN A STATEMENT ACKNOWLEDGING THEIR UNDERSTANDING AND ADHERENCE TO THE CONFLICT OF INTEREST POLICY. IN ADDITION TO THE REQUIREMENT OF AN ANNUAL COMPLETED DISCLOSURE FORM, IT IS THE CONTINUING RESPONSIBILITY OF THE DOSCLOSING INDIVIDUALS TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS OF INTEREST AND TO IMMEDIATELY MAKE SUCH DISCLOSURES. THE INDIVIDUALS REQUIRED TO COMPLETE THE DISCLOSURE FORM INCLUDE: BOARD MEMBERS, ADMINISTRATION (CAO, COO, AND CFO), AND MANAGERS OF MATERIALS MANAGEMENT, INFORMATION TECHNOLOGY, LAB, IMAGING, COMMUNITY RELATIONS/MARKETING, AND PLANT OPERATIONS. PART VI, SECTION B, LINES 15A AND 15B THE BOARD OF DIRECTORS DETERMINES AND APPROVES THE CAO'S SALARY BASED ON SURVEYS COMPARABILITY DATA AND AN OUTSIDE CONSULTING FIRM HAS BEEN USED AT TIMES. SALARIES OF OTHER MANAGEMENT EMPLOYEES ARE BASED ON MARKET SURVEYS ANALYZED BY THE HUMAN RESOURCES DEPARTMENT AND APPROVED BY THE ADMINISTRATIVE TEAM AND/OR THE CAO. PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. PART XI, LINE 9 LAKEVIEW MEDICAL CENTER PROVIDED A CASH DISTRIBUTION TO MARSHFIELD CLINIC OF $14,048,000. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| MARSHFIELD CLINIC | |||||||||
| 1000 North Oak Avenue | Marshfield | WI | 54449 | 390452970 | Medical Care | WI | 501(C)(3) | 3 | NA |
| VOLUNTEER PARTNERS OF LAKEVIEW MEDICAL | |||||||||
| 1700 WEST STOUT STREET | Rice Lake | WI | 54868 | 391329084 | Support Org. | WI | 501(C)(3) | 11, III-O | NA |
| SECURITY HEALTH PLAN OF WISCONSIN INC | |||||||||
| 1515 NORTH SAINT JOSEPHS AVENUE | MARSHFIELD | WI | 54449 | 391572880 | HMO | WI | 501(C)(4) | N/A | NA |
| THE HERITAGE FOUNDATION | |||||||||
| 1000 NORTH OAK AVENUE | MARSHFIELD | WI | 54449 | 391865942 | HONOR INDIVID | WI | 501(C)(3) | 11-TYPE 1 | NA |
| FLAMBEAU HOSPITAL INC | |||||||||
| 98 SHERRY AVENUE | PARK FALLS | WI | 54552 | 390973724 | HOSPITAL | WI | 501(C)(3) | 3 | NA |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|
| MARSHFIELD FOOD SAFETY | ||||||
| 201056380 | FOOD TESTING | WI | NA | RELATED | false | false |
| DIAGNOSTIC TREATMENT CENTER | ||||||
| 200691634 | MEDICAL SERVICES | WI | NA | RELATED | false | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | Yes (true) | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (true) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |