2015-05-14T14:58:29-05:00 2014-06-30 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2014-01-01 391999260 NORTHREACH HEALTHCARE LLC NORT 7157322078 3120 RIVERSIDE AVE GATE B BLDG 1 MARINETTE WI 54143 GEORGE KERWIN PRESIDENT AND CEO 7157322078 2015-05-13 1 TERRI REXRODE CPA MST P00096513 9206620016 2015-05-13 2014 2016-03-07 17:11:31Z X GEORGE KERWIN 3120 RIVERSIDE AVE GATE B BLDG 1 MARINETTE WI 54143 9241009 0 X WWW.NORTHREACH.ORG X LLC 2000 WI TO PROVIDE HEALTH CARE SERVICES TO PATIENTS THROUGH CLINICS LOCATED IN NORTHEASTERN WISCONSIN AND UPPER MICHIGAN. 8 4 0 0 0 0 7100000 2700000 13135126 6527064 -234 -14227 16215 7317 20251107 9220154 0 0 0 0 13191147 6150631 0 0 0 5959023 3416735 19150170 9567366 1100937 -347212 6611361 0 2226393 0 4384968 0 NORTHREACH HEALTHCARE WILL BE THE LEADING PROVIDER OF COMPASSIONATE, HIGH QUALITY PRIMARY HEALTH CARE IN THE COMMUNITIES WE SERVE. 0 0 7267137 6521862 TO PROVIDE CLINICAL HEALTH CARE SERVICES THROUGH HEALTH CARE PROFESSIONALS PRACTICING PRIMARILY IN PRIMARY CARE SPECIALTIES. NORTHREACH PROVIDES SERVICE TO MARINETTE COUNTY, MENOMINEE COUNTY, AND THE SURROUNDING AREAS. NORTHREACH IS A PRIMARY CARE ORGANIZATION WITH SERVICE LINES OF FAMILY PRACTICE, OB/GYN, PEDIATRICS, AND INTERNAL MEDICINE. IN 2014, THERE WERE APPROXIMATELY 49,640 VISITS FROM JAN-JUNE. AT THE END OF JUNE 2014, NORTHREACH EMPLOYED APPROXIMATELY 25 HEALTHCARE PROVIDERS AND 150 SUPPORT STAFF. NORTHREACH IS COMMITTED TO THE HEALTH OF THE COMMUNITY AND DEMONSTRATES THAT COMMITTMENT THRU ITS CHARITY CARE POLICY THRU WHICH APPROXIMATELY $17,900 OF SERVICES WERE PROVIDED AT FREE OR REDUCED COSTS TO INDIVIDUALS WHO WRE UNABLE TO PAY FOR SERVICE AND MET CERTAIN ELIGIBILITY CRITERIA. 7267137 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 4 0 0 0 0 1 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 WI X THERESA RIVARD 7157322078 3120 RIVERSIDE AVE MARINETTE WI 54143 X MARY GATZKE BOARD MEMBER 40.00 X 0 0 0 SANDRA MACARTHUR MD BOARD MEMBER 40.00 X 0 0 0 CHRIS WOLESKE BOARD MEMBER 0.50 X 0 0 0 JOHN ROCHELEAU BOARD MEMBER 0.50 X 0 0 0 DAN CARLSON BOARD MEMBER 0.50 X 0 0 0 BETH GOETZMAN BOARD MEMBER 40.00 X 0 0 0 ED HARDING BOARD MEMBER 0.50 X 0 0 0 C MARK GREGSON INTERIM CEO 40.00 X X 0 0 0 JAMES OPOIEN BOARD MEMBER 40.00 X 0 0 0 JILL BROWN ADMINISTRATIVE SERVICES DI 40.00 X 0 0 0 0 0 0 0 0 0 0 BAY AREA MEDICAL CENTER 3100 SHORE DRIVE MARINETTE WI 54143 REFERENCE LAB, RENT, AND INFORMATION TEC 1585381 JACKSON & COKER LOCUM TENENS LLC PO BOX 277638 ATLANTA GA 30384 LOCUM TENENS PHYSICIANS 671176 BELLIN MEDICAL GROUP 744 S WEBSTER AVE PO BOX 23400 GREEN BAY WI 54305 IT, WELLNESS, AND NURSE TRIAGE 510982 COMPHEALTH ASSOCIATES INC PO BOX 972625 DALLAS TX 75397 LOCUM TENENS PHYSICIANS 269038 MKD DEVELOPMENT W6325 CIRCLE DR CRIVITZ WI 54114 RENT AND MAINTENANCE 250044 6 2700000 2700000 NET PATIENT SERVICE RE 621110 6444442 6439240 5202 AFFILATE RENTS 621110 82622 82622 6527064 21 21 12174 4857 7317 7317 7317 1750 15998 -14248 -14248 -14248 9220154 6521862 0 -1708 X 719051 546409 172642 4120588 3294774 825814 109438 79731 29707 890802 351052 539750 310752 244598 66154 6807 4608 2199 1230250 1006019 224231 18556 18556 785541 469543 315998 10374 586 9788 569285 542176 27109 18282 4033 14249 13353 2481 10872 122 122 237628 225809 11819 59559 46439 13120 PROVISION FOR BAD DEBTS 298363 298363 FASTCARE EXPENSES 36522 36522 EMPLOYEE RECRUITMENT 31603 31399 204 DUES AND SUBSCRIPTIONS 20239 12602 7637 80251 51315 28936 9567366 7267137 2300229 0 511877 0 0 0 1817393 0 0 0 0 208728 0 242130 0 0 2992227 0 0 0 0 541466 0 297540 0 6611361 0 1879899 48954 297540 0 2226393 0 X 4384968 0 4384968 0 6611361 0 X -347212 -4037756 X 0 0 0 X SCHEDULE A REFERENCE NORTHREACH HEALTHCARE, LLC IS A NONPROFIT, LIMITED LIABILITY COMPANY THAT PROVIDES HEALTH CARE SERVICES THROUGH CLINICS LOCATED IN NORTHEASTERN WISCONSIN AND MICHIGAN. ITS EXEMPT STATUS WAS APPROVED UNDER IRC 509(A) (1) AND 170(B) (1) (A) (III). IT IS NOT REQUIRED TO BE LICENSED AS A HOSPITAL AND THEREFORE IS NOT REQUIRED TO COMPLETE SCHEDULE H. SCHEDULE A REFERENCE SHORT YEAR EXPLANATION: NORTHREACH HEALTHCARE, LLC WAS INITIALLY FORMED AS A TWO-MEMBER LIMITED LIABILITY COMPANY. ON JUNE 16, 2014, ALL OF THE LIMITED LIABILITY UNITS WERE PURCHASED BY BELLIN MEMORIAL HOSPITAL, INC. THEREFORE, FOR IRS PURPOSES, THIS ORGANIZATION IS DEEMED TO TECHNICALLY TERMINATE AND ALL FUTURE ACTIVITY WILL BE SHOWN ON THE FORM 990 FOR BELLIN MEMORIAL HOSPITAL, INC. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED ALL ASSETS AND LIABILITIES 2014-06-16 11700000 PRICE AGREED TO BY TWO NON-PROFIT ORGANIZATIONS. 390884478 BELLIN MEMORIAL HOSPITAL INC PO BOX 23400 GREEN BAY WI 54305 501(C)(3) 0 1 0 0 1 0 0 1 0 PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: SANDRA MACARTHUR, MARY GATZKE, BETH GOETZMAN, AND JAMES OPOIEN REMAINED EMPLOYEES OF NORTHREACH AFTER THE LIMITED LIABILITY COMPANY WAS TECHNICALLY TERMINATED. FORM 990, PART VI, SECTION A, LINE 6 NORTHREACH CONSISTS OF TWO MEMBERS: BELLIN MEMORIAL HOSPITAL, INC. AND BAY AREA MEDICAL CENTER, INC. THE BOARD OF DIRECTORS HAS INDIVIDUALS FROM NORTHREACH HEALTHCARE, BAY AREA MEDICAL CENTER AND BELLIN MEMORIAL HOSPITAL. BELLIN MEMORIAL HOSPITAL AND BAY AREA MEDICAL CENER ARE MEMBERS OF NORTHREACH HEALTHCARE. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED BY ACCOUNTING STAFF. IN ADDITION A COPY OF THE FORM 990 IS DISTRIBUTED AND REVIEWED BY A SUBSET OF THE BOARD OF DIRECTORS THAT IS CREATED SPECIFICALLY FOR THE PURPOSE OF FORM 990 REVIEW AND APPROVAL. AFTER APPROVAL, IT IS ELECTRONICALLY FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, OFFICER AND COMMITTEE MEMBER SHALL DISCLOSE TO THE BOD OR TO THE OTHER MEMBERS OF ANY COMMITTEE CONSIDERING A PROPOSED TRANSACTION OR ARRANGEMENT, THE EXISTENCE OF ANY FINANCIAL INTEREST AND ALL MATERIAL FACTS SUCH PERSON MAY HAVE WITH RESPECT TO SUCH PROPOSED TRANSACTION OR ARRANGEMENT. EACH DIRECTOR, OFFICER AND COMMITTEE MEMBER SHALL PROMPTLY MAKE DISCLOSURES AS MAY BE NECESSARY TO KEEP THE BOARD OR COMMITTEE FULLY APPRISED OF SUCH PERSON'S FINANCIAL INTERESTS. DISCLOSURE SHALL ALSO BE ACCOMPLISHED ON AN ANNUAL BASIS BY HAVING EACH DIRECTOR AND PRINCIPAL OFFICER EXECUTE AND DELIVER TO THE COMPANY A CERTIFICATE REGARDING CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A A REVIEW IS PERFORMED BY BELLIN HUMAN RESOURCE STAFF AND APPROVED BY BELLIN AND BAY AREA MEDICAL CENTER. BENCHMARK DATA IS STUDIED FOR SIMILAR POSITIONS AND CONSIDERED (ALONG WITH PERFORMANCE) WHEN DETERMINING THE COMPENSATION AND ANY PAY INCREASES AND/OR BONUS PAYMENTS. THE COMPENSATION, PAY INCREASE, OR BONUS IS APPROVED BY THE CEOS OF THE TWO OWNERS (BAY AREA MEDICAL CENTER AND BELLIN). THE INFORMATION IS DOCUMENTED AND THE DECISIONS ARE MADE BY INDIVIDUALS WHO DO NOT HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PUCHASED SERVICES - MISCELLANEOUS: PROGRAM SERVICE EXPENSES 184,501. MANAGEMENT AND GENERAL EXPENSES 224,231. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 408,732. PUCHASED SERVICES - LAB SERVICES: PROGRAM SERVICE EXPENSES 140,311. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 140,311. PUCHASED SERVICES - PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 602,178. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 602,178. PUCHASED SERVICES - MID-LEVEL SERVICES: PROGRAM SERVICE EXPENSES 29,485. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,485. PUCHASED SERVICES - MEDICAL SUPPORT: PROGRAM SERVICE EXPENSES 14,095. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,095. PUCHASED SERVICES - X-RAY AND RADIOLOGY: PROGRAM SERVICE EXPENSES 35,449. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,449. FORM 990, PART XI, LINE 9: EQUITY TRANSFER -4,037,756.