OCONTO HOSPITAL & MEDICAL CENTER INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- OCONTO HOSPITAL & MEDICAL CENTER INC (EIN 06-1745397)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-14
- IRS object ID
- 201422269349303022
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-14T14:10:05-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390758449 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12237 | AddressLine1 |
| City | GREEN BAY | City |
| State | WI | State |
| ZIP Code | 543072237 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061745397 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OCONTO HOSPITAL AND MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | OCON | NameControl |
| Phone | 9208351100 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 357 | AddressLine1 |
| City | OCONTO | City |
| State | WI | State |
| ZIP Code | 54153 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CHRISTINE WOLESKE | Name |
| Title | CEO | Title |
| Phone | 9208351100 | Phone |
| Date Signed | 2014-08-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TERRI REXRODE CPA MST | Name |
| PTIN | P00096513 | PTIN |
| Phone | 9206620016 | Phone |
| Date Prepared | 2014-08-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CHRISTINE WOLESKE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 357 | AddressLine1 |
| City | OCONTO | City |
| State | WI | State |
| ZIP Code | 54153 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 10367025 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.OCONTOHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2005 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | OCONTO HOSPTIAL & MEDICAL CENTER, INC. (THE ORGANIZATION) IS YOUR HOME TOWN HOSPITAL, CREATED TO MAKE OUTSTANDING HEALTHCARE CONVENIENT. BACKED BY THE RESOURCES OF BELLIN HEALTH, OCONTO HOSPITAL & MEDICAL CENTER, INC. OFFERS OUTSTANDING HOSPITAL-BASED, EMERGENCY AND PRIMARY CARE SERVICES. OCONTO HOSPITAL & MEDICAL CENTER, INC. OFFERS THE CARE YOU NEED WHERE YOU WANT IT. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 77 | TotalNbrEmployees |
| Total Nbr Volunteers | 8 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1482000 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 423807 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 5622385 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 9888992 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2001 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3813 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -840 | OtherRevenuePriorYear |
| Other Revenue Current Year | 37353 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 7105546 | TotalRevenuePriorYear |
| Total Revenue Current Year | 10353965 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 2994332 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4851357 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2800839 | OtherExpensePriorYear |
| Other Expenses Current Year | 6665493 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 5795171 | TotalExpensesPriorYear |
| Total Expenses Current Year | 11516850 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1310375 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1162885 | RevenuesLessExpensesCY |
| Total Assets BOY | 26367419 | TotalAssetsBOY |
| Total Assets EOY | 26480927 | TotalAssetsEOY |
| Total Liabilities BOY | 21143664 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 22771278 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 5223755 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3709649 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF OCONTO HOSPITAL & MEDICAL CENTER IS TO PROVIDE 24-HOUR LOCAL ACCESS TO EFFECTIVE, EFFICIENT HEALTH, WELLNESS AND PREVENTATIVE SERVICES TO OCONTO AND THE SURROUNDING RURAL COMMUNITIES. TOWARD THIS PURPOSE, OCONTO HOSPITAL & MEDICAL CENTER WORKS IN PARTNERSHIP WITH THE COMMUNITY, THE CITIZENS HOSPITAL FOUNDATION AND BELLIN HEALTH. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 1 | SignificantChange |
| Expense | 8931898 | Expense |
| Revenue | 9885219 | Revenue |
| Description | AS A KEY REGIONAL ASSET, THE ORGANIZATION IS A NOT-FOR-PROFIT HEALTHCARE PROVIDER. THE ORGANIZATION PROVIDES ACUTE HOSPITAL, EMERGENCY AND URGENT CARE TO RESIDENTS OF OCONTO WISCONSIN AND THE SURROUNDING COMMUNITIES. DURING THE PERIOD OF OCTOBER 1, 2012 TO SEPTEMBER 30, 2013, 539 INPATIENT DAYS WERE PROVIDED 167 SWING BED DAYS WERE PROVIDED. THE NUMBER OF OUTPATIENTS REGISTERED DURING THE SAME 12 MONTH PERIOD WAS 10,877. | Description |
| Total Program Service Expense | 8931898 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 77 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SARA ARNDT | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9204457260 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2020 SOUTH WEBSTER AVE | AddressLine1 |
| City | GREEN BAY | City |
| State | WI | State |
| ZIP Code | 54301 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (9 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| CHRISTINE WOLESKE | ||||||||
| CEO | 0.50 | 50.00 | X | X | 0 | 341470 | 34758 | |
| GEORGE KERWIN | ||||||||
| BOARD MEMBER | 0.50 | 50.00 | X | 0 | 877514 | 37717 | ||
| SARA ARNDT | ||||||||
| BOARD MEMBER | 5.00 | 40.00 | X | 0 | 48965 | 20694 | ||
| DAVID HONISH | ||||||||
| CHAIRPERSON | 0.50 | X | X | 0 | 0 | 0 | ||
| RODNEY R JOHNSON | ||||||||
| SECRETARY/TREASURER | 0.50 | X | X | 0 | 0 | 0 | ||
| LAURA CORMIER | ||||||||
| VP OF OPERATIONS | 45.00 | X | 122393 | 0 | 18868 | |||
| CHARLES HEYKA MD | ||||||||
| BOARD MEMBER | 14.00 | 36.00 | X | 66595 | 202376 | 27771 | ||
| JOHN HONISH | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| ROBERT BIVINS MD | ||||||||
| PHYSICIAN | 40.00 | 242969 | 0 | 28813 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 431957 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1470325 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 168621 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| IEI GENERAL CONTRACTORS INC | |||||
| PO BOX 5067 | DE PERE | WI | 541555067 | CONTRACTOR SERVICES | 6232637 |
| BELLIN MEMORIAL HOSPITAL INC | |||||
| 744 S WEBSTER AVE | GREEN BAY | WI | 54305 | MANAGEMENT SERVICES | 782414 |
| JIN KIM MD | |||||
| 333 W MIFFLIN ST 1167 | MADISON | WI | 53703 | CONTRACTED ED PHYSICIAN SERVICES | 268189 |
| SOMERVILLE INC | |||||
| 2100 RIVERSIDE DR | GREEN BAY | WI | 54301 | ARCHITECT AND DESIGN SERVICES | 131401 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Related Organizations | 415000 | RelatedOrganizations |
| Government Grants | 8807 | GovernmentGrants |
| Total Contributions | 423807 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| NET PATIENT REVENUE | 621300 | 9762077 | 9762077 | |
| RENT FROM AFFILIATES | 900099 | 123142 | 123142 | |
| MISCELLANEOUS REVENUE | 900099 | 3773 | $3,773 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 9888992 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3813 | TotalRevenueColumn |
| Exclusion | $3,813 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 50413 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 13060 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 37353 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 37353 | TotalRevenueColumn |
| Exclusion | $37,353 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10353965 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9885219 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $44,939 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 216492 | Total |
| Program Services | 74871 | ProgramServices |
| Management And General | 141621 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3917286 | Total |
| Program Services | 3747743 | ProgramServices |
| Management And General | 169543 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 176908 | Total |
| Program Services | 173501 | ProgramServices |
| Management And General | 3407 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 273923 | Total |
| Program Services | 268925 | ProgramServices |
| Management And General | 4998 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 266748 | Total |
| Program Services | 251537 | ProgramServices |
| Management And General | 15211 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12673 | Total |
| Management And General | 12673 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6884 | Total |
| Management And General | 6884 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1244784 | Total |
| Program Services | 539478 | ProgramServices |
| Management And General | 705306 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 328608 | Total |
| Management And General | 328608 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1580986 | Total |
| Program Services | 1561232 | ProgramServices |
| Management And General | 19754 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41322 | Total |
| Program Services | 2036 | ProgramServices |
| Management And General | 39286 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 239702 | Total |
| Program Services | 232683 | ProgramServices |
| Management And General | 7019 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41256 | Total |
| Program Services | 32124 | ProgramServices |
| Management And General | 9132 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6000 | Total |
| Management And General | 6000 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 914760 | Total |
| Management And General | 914760 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1637738 | Total |
| Program Services | 1494702 | ProgramServices |
| Management And General | 143036 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14470 | Total |
| Program Services | 9314 | ProgramServices |
| Management And General | 5156 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 537636 | 537636 | |
| DUES, LICENSES AND SUBS | 52890 | 6116 | 46774 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5784 | Total |
| Management And General | 5784 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11516850 | Total |
| Program Services | 8931898 | ProgramServices |
| Management And General | 2584952 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 303291 | BOY |
| EOY | 707124 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33050 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2007951 | BOY |
| EOY | 2302668 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 146211 | BOY |
| EOY | 308193 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 26830546 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4182524 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22695216 | BOY |
| EOY | 22648022 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1181700 | BOY |
| EOY | 514920 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26367419 | BOY |
| EOY | 26480927 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 675816 | BOY |
| EOY | 925797 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14000000 | BOY |
| EOY | 13649999 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6467848 | BOY |
| EOY | 8195482 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21143664 | BOY |
| EOY | 22771278 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4642293 | BOY |
| EOY | 3479406 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 581462 | BOY |
| EOY | 230243 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5223755 | BOY |
| EOY | 3709649 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26367419 | BOY |
| EOY | 26480927 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1162885 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -351221 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 661050 | OtherCostOrOtherBasis |
| Book Value | 661050 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15005641 | OtherCostOrOtherBasis |
| Depreciation | 1748255 | Depreciation |
| Book Value | 13257386 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 171971 | OtherCostOrOtherBasis |
| Depreciation | 32265 | Depreciation |
| Book Value | 139706 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10991884 | OtherCostOrOtherBasis |
| Depreciation | 2402004 | Depreciation |
| Book Value | 8589880 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 22648022 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO AFFILIATE | Description |
| Amount | $8,195,482 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 8195482 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 9970775 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 18750 | OtherRevenues |
| Revenue Not Rptd F990 | 18750 | RevenueNotRptdF990 |
| Revenue Subtotal | 9952025 | RevenueSubtotal |
| Other Revenues Not Included | 401940 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 401940 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 10353965 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 11548660 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 13060 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 13060 | ExpensesNotRptdF990 |
| Expenses Subtotal | 11535600 | ExpensesSubtotal |
| Other Expenses Not Included | -18750 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | -18750 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 11516850 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | IN ORDER TO ACCOUNT FOR UNCERTAIN TAX POSITIONS, BELLIN HEALTH SYSTEMS DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. BELLIN HEALTH SYSTEMS HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF SEPTEMBER 30, 2013 OR 2012. BELLIN HEALTH SYSTEMS' FEDERAL INCOME TAX RETURNS FOR YEARS ENDED SEPTEMBER 30, 2010, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE EXPIRATION OF THE STATUTES OF LIMITATIONS RELATED TO THE VARIOUS STATE INCOME TAX RETURNS THAT BELLIN HEALTH SYSTEMS FILE VARIES BY STATE. GENERALLY, BELLIN HEALTH SYSTEMS' VARIOUS STATE INCOME TAX RETURNS FOR YEARS ENDED SEPTEMBER 30, 2009, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY VARIOUS STATE TAXING AUTHORITIES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RECLASS BETWEEN REVENUE AND EXPENSES 18,750. | |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL DEPRECIATION -13,060. OCONTO MEMORIAL HOSPITAL CITIZENS FOUNDATION, INC. REVENUE 375,000. BELLIN FOUNDATION REVENUE 40,000. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL DEPRECIATION 13,060. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | RECLASS BETWEEN REVENUE AND EXPENSES -18,750. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 295679 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 295679 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02690 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1857970 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1376501 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 481469 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04390 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2153649 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1376501 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 777148 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07080 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 696 | PersonsServed |
| Total Community Benefit Expense | 5321 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 5321 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17235 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7515 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9720 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 767 | PersonsServed |
| Total Community Benefit Expense | 3602 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3602 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 1463 | PersonsServed |
| Total Community Benefit Expense | 26158 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7515 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 18643 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 1463 | PersonsServed |
| Total Community Benefit Expense | 2179807 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1384016 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 795791 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07250 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $537,636 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 2608584 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 2692666 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -84082 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OCONTO HOSPITAL & MEDICAL CENTER INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 820 ARBUTUS AVE | AddressLine1 |
| City | OCONTO | City |
| State | WI | State |
| ZIP Code | 54153 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OCONTO HOSPITAL & MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART I, LINE 6A: BELLIN MEMORIAL HOSPITAL, INC. | |
| PART I, LINE 7: AMOUNTS ARE CALCULATED BASED ON THE COST TO CHARGE RATIOS AND WORKSHEET 2 PROVIDED BY THE IRS. | |
| PART I, L7 COL(F): BAD DEBT EXPENSE OF $537,636 INCLUDED ON FORM 990, PART IX, LINE 25 WAS EXCLUDED FROM THE DENOMINATOR PER INSTRUCTIONS WHEN CALCULATING THE PERCENT TOTAL EXPENSES ON SCHEDULE H. | |
| PART II: THE ORGANIZATION REPORTED NO COMMUNITY BUILDING ACTIVITIES REPORTED IN PART II. | |
| PART III, LINE 4: THE ATTACHED FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC BAD DEBT EXPENSE FOOTNOTE. HOWEVER, THE SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES DESCRIBES THE PROVISION FOR BAD DEBT ON PAGE 11 OF THE FINANCIAL STATEMENTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL), BELLIN HEALTH SYSTEMS RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCES FOR DOUBTFUL ACCOUNTS. | |
| PART III, LINE 8: THE AMOUNTS REPORTED FOR MEDICARE WERE CALCULATED USING A COST TO CHARGE RATIO. THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT FOR THE FOLLOWING REASONS. IRS REV RUL 69-545 WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. IN ADDITION, ELDERLY PATIENTS ARE OFTEN UNDERSERVED AND EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT EXEMPT HOSPITALS, CMS WOULD NEED TO PROVIDE THESE SERVICES. | |
| PART III, LINE 9B: WHEN A PATIENT QUALIFIES FOR CHARITY CARE HIS/HER ACCOUNT BALANCE ARE ADJUSTED TO REFLECT THE PORTION OF THE CHARGES THAT HE/SHE ARE STILL RESPONSIBLE FOR PAYING. IF THOSE PAYMENTS ARE NOT MADE AND THE PATIENT DOES NOT QUALIFY FOR ADDITIONAL ASSISTANCE, THE COLLECTORS WILL FOLLOW THE STANDARD WRITTEN COLLECTION POLICY. | |
| PART V, SECTION B, LINE 3: DEVELOPED COUNTY WIDE INDIVIDUAL PUBLIC OPINION SURVEY THAT GENERATED OVER 600 RESPONSES. ASSESSMENT TEAM INCLUDED PARTICIPATION FROM SCHOOLS, LAW ENFORCEMENT, EMPLOYERS, HEALTHCARE PROVIDERS, CHURCHES, COUNTY AGENICES, UNITED WAY, PUBLIC OFFICIALS, PUBLIC HEALTH AND HEALTHCARE MEDICAL PROVIDERS. | OCONTO HOSPITAL & MEDICAL CENTER, INC. |
| PART V, SECTION B, LINE 4: COMMUNITY MEMORIAL HOSPITAL, OCONTO FALLS, WISCONSIN | OCONTO HOSPITAL & MEDICAL CENTER, INC. |
| PART V, SECTION B, LINE 5C: MADE AND CONTINUE TO MAKE PRESENTATIONS TO COMMUNITY ENTITIES THROUGHOUT THE COUNTY INCLUDING SCHOOLS, GOVERNMENT BOARDS, CHAMBER OF COMMERCE, AND CIVIC GROUPS.THE CHNA IS AVAILABLE AT THE ORGANIZATION'S WEBSITE: WWW.BELLIN.ORG | OCONTO HOSPITAL & MEDICAL CENTER, INC. |
| PART V, SECTION B, LINE 7: AS A COUNTY ASSESSMENT TEAM, WE PRIORITIZED THREE HEALTH FOCUS AREAS FOR THE NEXT 5 YEARS. | OCONTO HOSPITAL & MEDICAL CENTER, INC. |
| PART V, SECTION B, LINE 20D: PATIENTS CAN QUALIFY FOR COMMUNITY CARE OR A DISCOUNT DEPENDING ON LEVEL OF QUALIFICATION PRIMARILY DEPENDENT ON INCOME LEVEL AND FAMILY SIZE. THE DISCOUNT IS TAKEN FROM 80% OF GROSS CHARGES. A FAP ELIGIBLE PATIENT WILL NEVER BE RESPONSIBLE FOR MORE THAN 15% OF THEIR ANNUAL INCOME. | OCONTO HOSPITAL & MEDICAL CENTER, INC. |
| PART VI, LINE 2: DURING THE FISCAL YEAR, THE ORGANIZATION DEVELOPED A COUNTY WIDE INDIVIDUAL PUBLIC OPINION SURVEY, WHICH GENERATED 600 RESPONSES. THE RESPONSES WERE GATHERED FROM A VARIETY OF SOURCES, WHICH INCLUDED BUT WERE NOT LIMITED TO SCHOOLS, LAW ENFORCEMENT, HEALTHCARE PROVIDERS, CHURCHES, COUNTY AGENCIES, THE UNITED WAY, PUBLIC OFFICIALS, AND PUBLIC HEALTH DEPARTMENTS. THE VARIETY OF ORGANIZATIONS THAT RESPONDED ALLOWED THE ORGANIZATION TO APPROPRIATELY ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY. | |
| PART VI, LINE 3: INFORMATION ON GOVERNMENT ASSISTANCE PROGRAMS AND THE CHARITY CARE PROGRAM IS MADE AVAILABLE TO PATIENTS IN THE EMERGENCY ROOM AND AT THE TIME OF REGISTRATION. ADDITIONALLY, THE INFORMATION IS INCLUDED IN PATIENT STATEMENTS AND LETTERS FROM THE BILLING OFFICE. | |
| PART VI, LINE 4: THE ORGANIZATION IS LOCATED IN THE CITY OF OCONTO, WISCONSIN. ITS PRIMARY SERVICE AREA IS THE CITY OF OCONTO AND ITS SECONDARY SERVICE AREA SPREADS TO THE NORTHERN PORTION OF OCONTO COUNTY AND SOUTHERN MARINETTE COUNTY. THE CITY OF OCONTO HAS A POPULATION OF 4,500. 17% OF THE POPULATION IS OVER AGE 65 AND 8.8% OF THE POPULATION IS BELOW THE POVERTY LINE. | |
| PART VI, LINE 5: THE ORGANIZATION IS INVOLVED IN THE OCONTO/MARINETTE WELLNESS COALITION, OCONTO AREA CHAMBER OF COMMERCE BUSINESS EXPO, COPPERFEST SPONSORSHIP, NEWCAP AND HUMANE SOCIETY FOOD DRIVES. IN ADDITION THE ORGANIZATION IS A SOLE COMMUNITY HOSPITAL WITH AN EMERGENCY ROOM AVAILABLE TO ALL. | |
| PART VI, LINE 6: THE ORGANIZATION, IN PARTNERSHIP WITH BELLIN HEALTH SYSTEMS, INC., CONTINUES TO SERVE IT'S COMMUNITY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHRISTINE WOLESKE | ||||||||||||||
| CEO | 0 | 281200 | 0 | 60000 | 0 | 270 | 0 | 13675 | 0 | 21083 | 0 | 376228 | 0 | 0 |
| GEORGE KERWIN | ||||||||||||||
| BOARD MEMBER | 0 | 414658 | 0 | 453500 | 0 | 9356 | 0 | 21611 | 0 | 16106 | 0 | 915231 | 0 | 0 |
| CHARLES HEYKA MD | ||||||||||||||
| BOARD MEMBER | 55104 | 186544 | 10717 | 15832 | 774 | 0 | 2877 | 5421 | 5399 | 14074 | 74871 | 221871 | 0 | 0 |
| ROBERT BIVINS MD | ||||||||||||||
| PHYSICIAN | 238301 | 0 | 4398 | 0 | 270 | 0 | 13262 | 0 | 15551 | 0 | 271782 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 391337855 | IssuerEIN |
| Date Issued | 2011-08-18 | DateIssued |
| Issue Price | 14000000 | IssuePrice |
| Description Of Purpose | FACILITY AND SERVICE EXPANSION | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 350000 | AmountRetired |
| Capitalized Interest | 36149 | CapitalizedInterest |
| Issuance Costs From Proceeds | 132033 | IssuanceCostsFromProceeds |
| Capital Expenditures | 13831818 | CapitalExpenditures |
| Year Of Subst Completion | 2012 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 1 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 1 | RebateNotDueYet |
| Exception To Rebate | 0 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | 1 | ProcToUndertkCorrectiveAction |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| CHANGES IN PROGRAM SERVICES | FORM 990, PART III, LINE 3 | THE OUTPATIENT SURGERY DEPARTMENT OPENED ON 10/01/12. THIS NEW SERVICE INCLUDES NON-EMERGENT OUTPATIENT SURGERIES AND GI PROCEDURES. |
| FORM 990, PART VI, SECTION A, LINE 2 | JOHN HONISH AND DAVID HONISH HAVE A FAMILY RELATIONSHIP. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS TWO MEMBERS, BELLIN MEMORIAL HOSPITAL, INC. AND OCONTO MEMORIAL HOSPITAL CITIZENS FOUNDATION, INC. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS OF THE ORGANIZATION HAVE THE POWER TO APPOINT/ELECT THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE MEMBERS ALSO HAVE THE POWER TO APPROVE, BUT NOT LIMITED TO, THE PHILOSOPHY, MISSION, AND VALUE OF THE ORGANIZATION, STRATEGIC PLANS, THE ANNUAL OPERATING AND CAPITAL BUDGET, AMENDMENTS OR RESTATEMENTS OF THE ARTICLES OF INCORPORATION AND BYLAWS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED IN DETAIL BY SENIOR ADMINISTRATION AND IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUESTS AN ANNUAL UPDATE FROM ALL MEMBERS WHO SIGN THE POLICY. MEMBERS OF THE BOARD WHO HAVE A CONFLICT OF INTEREST WITH A BOARD DECISION ABSTAIN FROM VOTING ON THE ISSUE. | |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION OF KEY EXECUTIVES ARE SET BY THE EXECUTIVE COMMITTEE OF THE BOARD WITHOUT CONFLICT OF INTEREST AND IS SUPPORTED BY MARKET DATA FROM SURVEYS AND AN INDEPENDENT CONSULTANT'S REPORT. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION CONSIDERS THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS PROPERTY OF THE ORGANIZATION AND THEREFORE ARE NOT AVAILABLE TO THE PUBLIC. | |
| OTHER FEES | FORM 990, PART IX, LINE 11G | INTERCOMPANY IT SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 570,528. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 570,528. INTERCOMPANY MANGEMENT CHARGES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 134,778. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 134,778. CONTRACTED LABOR: PROGRAM SERVICE EXPENSES 349,768. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 349,768. CONTRACTED LABOR - ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 189,710. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 189,710. |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN THE BELLIN HEALTH FOUNDATION, INC. -40,000. CHANGE IN INTEREST IN OCONTO MEMORIAL HOSPITAL CITIZENS' FOUNDATION, INC. -311,221. |
| FORM 990, PART XI, LINE 2B-2C | THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED AUDIT OF BELLIN HEALTH SYSTEMS, INC. THE BOARD OF DIRECTORS OF BELLIN HEALTH SYSTEMS, INC. ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT AUDITOR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OCONTO MEMORIAL HOSPITAL CITIZENS FOUNDATION | |||||||||||
| 405 1ST STRET | OCONTO | WI | 54153 | 061745397 | SUPPORTING ORGANIZATION | WI | 501(C) | LINE 11B, II | N/A | 0 | |
| LAKE MICHIGAN HEALTH SERVICES INC | |||||||||||
| 744 SOUTH WEBSTER AVE | GREEN BAY | WI | 54305 | 391512903 | SUPPORT PURPOSES OF BELLIN MEMORIAL HOSPITAL | WI | 501(C) | LINE 11B, II | 1 | BELLIN HEALTH SYSTEMS INC | |
| BELLIN COLLEGE INC | |||||||||||
| 3201 EATON ROAD | GREEN BAY | WI | 54311 | 391620530 | NURSING AND RADIOLOGIC SCIENCE COLLEGE | WI | 501(C) | LINE 2 | 1 | BELLIN HEALTH SYSTEMS INC | |
| THE BELLIN HEALTH FOUNDATION INC | |||||||||||
| PO BOX 23400 | GREEN BAY | WI | 54305 | 391809171 | FOUNDATION | WI | 501(C) | LINE 7 | 1 | BELLIN HEALTH SYSTEMS INC | |
| BELLIN PSYCHIATRIC CENTER INC | |||||||||||
| PO BOX 23725 | GREEN BAY | WI | 54305 | 391657627 | PPSYCHIATRIC HOSPITAL | WI | 501(C) | LINE 3 | 1 | BELLIN HEALTH SYSTEMS INC | |
| BELLIN MEMORIAL HOSPITAL INC | |||||||||||
| PO BOX 23400 | GREEN BAY | WI | 54305 | 391900586 | ACUTE CARE HOSPITAL | WI | 501(C) | LINE 3 | 1 | BELLIN HEALTH SYSTEMS INC | |
| BELLIN HEALTH SYSTEMS INC | |||||||||||
| 744 SOUTH WEBSTER AVE | GREEN BAY | WI | 54305 | 391512904 | SUPPORT OF HEALTHCARE ORGANIZATIONS | WI | 501(C) | LINE 11B, II | N/A | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BELLIN ORTHOPEDIC SURGERY CENTER LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2223 LIME KILN RD | AddressLine1 |
| City | GREEN BAY | City |
| State | WI | State |
| ZIP Code | 54311 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 264677834 | EIN |
| Primary Activity | AMBULATORY ORTHOPEDIC SURGERY | PrimaryActivity |
| Legal Domicile State | WI | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| BEL-REGIONAL HOME MEDICAL INC | |||||||||
| 617 S ROOSEVELT | GREEN BAY | WI | 54301 | 391504766 | DURABLE MEDICAL EQUIPMENT, RETAIL PHARMACY, FITNESS | WI | N/A | C | 0 |
| BELLIN INVESTMENTS INC | |||||||||
| PO BOX 23400 | GREEN BAY | WI | 54305 | 391564939 | OTHER | WI | N/A | C | 0 |
| UNITED PROVIDERS INC | |||||||||
| PO BOX 23400 | GREEN BAY | WI | 54305 | 391907541 | OTHER | WI | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| OCONTO MEMORIAL HOSPITAL CITIZENS FOUNDATION | ||
| C | 375000 | FMV |
| BELLIN HEALTH FOUNDATION INC | ||
| C | 40000 | FMV |
| BELLIN MEMORIAL HOSPITAL INC | ||
| E | 14000000 | FMV |
| BEL-REGIONAL HOME MEDICAL INC | ||
| I | 120000 | FMV |
| BELLIN MEMORIAL HOSPITAL INC | ||
| L | 782414 | FMV |
| BELLIN MEMORIAL HOSPITAL INC | ||
| N | 374052 | FMV |
| BELLIN MEMORIAL HOSPITAL INC | ||
| O | 4200000 | FMV |
| BELLIN MEMORIAL HOSPITAL INC | ||
| E | 7483756 | FMV |
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