2014-10-23T10:00:26-05:00 2014-06-30 SVA CERTIFIED PUBLIC ACCOUNTANTS 1221 JOHN Q HAMMONS DRIVE MADISON WI 53717 990 2013-07-01 300072647 WISCONSIN DIALYSIS INC % MEGAN ISAACSON WISC 6082705600 3034 FISH HATCHERY ROAD Suite MADISON WI 537133125 MARK HAMILTON SECRETARY & ADMIN. DIRECTOR 6082705600 2014-10-20 true KIRSTEN HOUGHTON P01273230 6082705600 2014-10-15 2013 2015-11-30 17:44:51Z MARK HAMILTON 3034 FISH HATCHERY ROAD MADISON WI 537133125 12878771 false X www.wisconsindialysis.org X 2002 WI TO PROVIDE OUTPATIENT KIDNEY DIALYSIS TREATMENTS FOR PATIENTS IN A CLINIC OR HOME BASED SETTING ACCORDING TO THE REGULATIONS ESTABLISHED BY THE CENTERS FOR MEDICARE & MEDICAID. 4 4 0 2 0 2565 2441 10796129 12838907 548 2849 30453 34574 10829695 12878771 0 0 0 0 0 0 0 0 0 9571229 10443164 9571229 10443164 1258466 2435607 8779822 10492603 1110010 387184 7669812 10105419 X WISCONSIN DIALYSIS, INC. (WDI) EXISTS IN ORDER TO CARRY OUT THE FOLLOWING FOUR-PART MISSION: 1) PROVIDE EXCEPTIONAL, INDIVIDUALIZED AND FAMILY-CENTERED PATIENT CARE BY MEETING AND EXCEEDING RECOGNIZED NATIONAL STANDARDS OF HIGH QUALITY DIALYSIS CARE, INCLUDING TO THE EXTENT THAT CAN BE AFFORDED, FOR PATIENTS UNABLE TO PAY OR WITH LIMITED INSURANCE COVERAGE THAT PAYS LESS THAN WDI'S COST; 2) SUPPORT CLINICAL RESEARCH TO THE EXTENT THAN CAN BE AFFORDED TO HELP ADVANCE THE CLINICAL CARE QUALITY AND QUALITY OF LIFE FOR PEOPLE WITH KIDNEY DISEASE; 3) SERVE AS A CLINICAL EDUCATION AND PRACTICE SITE TO HELP TRAIN FUTURE HEALTH CARE STAFF AND PROVIDERS IN NEPHROLOGY; AND 4) SUPPORT COMMUNITY SERVICE PROGRAMS WORKING TO IMPROVE THE HEALTH AND LIVES OF PATIENTS WITH KIDNEY DISEASE. SINCE CARE IS PROVIDED AT LESS THAN COST TO MORE THAN 75% OF THE PATIENTS AT WDI, MEETING THE LIFE SUSTAINING MEDICAL NEEDS OF ESRD PATIENTS IN THE DANE COUNTY REGION IS THE PRIMARY MOTIVATION FOR OFFERING DIALYSIS SE false false 5863962 7350244 A total of 21,229 kidney dialysis treatments were provided to 263 chronic patients and 78 traveling patients at the Fitchburg Clinic from 7/1/2013 through 6/30/2014. Treatment of patients insured by Medicare and Medicaid accounted for 71% of all WDI activity and due to being provided at a financial loss, is considered a type of quasi community service to meet the medical needs of Dane county patients with kidney failure. With a cost per treatment of ~$288 and a Medicare/Medicaid payment rate per treatment of ~$262, the total calculated loss from serving patients with Medicare and Medicaid coverage is estimated to be over $391,872 annually. Care provided at a loss to undocumented residents with Emergency Medical Assistance insurance meets the stricter definition of charity care and the totaled $84,285 for the year. Most ESRD patients qualify for Medicaid or Wisconsin Chronic Disease Program coverage so actual charity care for WI residents totaled only $6,772 for the year. WDI resources were used to provide uncompensated support for assisting with nephrology fellowship training to five physicians in fellowships and nine nutrition students as part of their clinical training in University of Wisconsin educational programs. Selected quality data is shown below as compared to standardized national figures from the 2013 Dialysis Facility Report: - Mortality ratio was 8% lower than expected. - First year mortality ratio was 2% lower than expected. - Hospitalization rate was 2% lower than expected. - Hospitalization rate due to infection was 7.2% compared to 10.6% nationally. - Hospitalization days were 24% lower than expected. - The transplant rate for patients under age 70 was 12% compared to only 6% nationally. - The WDI PD catheter infection rate was 4.4 per 100 patient days vs. 3.05 nationally. - 64% of WDI patients received an influenza vaccine compared to 70% nationally. 1775552 3797454 A total of 8,322 kidney dialysis treatments were provided to chronic patients in the Home Program from 7/1/2013 through 6/30/2014. Please see the impact of Medicare and Medicaid activity described in Program Services #1. Please see the unfunded educational support provided by WDI as reported in Program Services #1. Please see quality data reported for Program Services #1. For the Home Programs, another quality measure to report is that 22% of WDI patients are in the Home program as compared to only ~8% nationally. Home patients are known to experience fewer infections and hospitalizations, require fewer medications, and score higher on quality of life surveys than their in-center hemodialysis patient counterparts. 1261793 1691209 A total of 4,718 kidney dialysis treatments were provided to 58 chronic patients and 7 traveling patients at the East Clinic from 7/1/2013 through 6/30/2014. Please see the impact of Medicare and Medicaid activity described in Program Services #1. Please see the unfunded educational support provided by WDI is as reported in Program Services #1. Selected quality data is shown below as compared to standardized national figures from the 2013 Dialysis Facility Report: - Mortality ratio was 23% lower than expected. - Hospitalization rate was 36% lower than expected. - Hospitalization rate due to infection was 8.7% compared to 10.6% nationally. - Hospitalization days were 35% lower than expected. - 81% of WDI patients received an influenza vaccine compared to 70% nationally. 8901307 true false false false false false false false false false true false false false true true true false false false false false false false false false false false false true false false false false false false false false false false false false false false false false false true 0 0 0 false false false false false false X 4 4 false true false false true true false true true false false true true true true true true false false false X MEGAN ISAACSON 6082650166 301 S WESTFIELD ROAD STE 350 MADISON WI 53717 X X MARK A HAMILTON INTERIM PRES.,SEC. & ADMIN DIR 40.0 0.0 X X 0 0 0 JOHN J HENSEY SEC.&ADMIN DIR.-TERMED 1/2014 40.0 0.0 X X 156382 0 59425 MICHAEL BUHL TREASURER 1.0 0.0 X X 0 0 0 KEVIN BOREN PRESIDENT - TERMED 11/2013 1.0 0.0 X 0 0 0 CLAUDIA J SANDERS DIRECTOR - TERMED 11/2013 1.0 0.0 X 0 0 0 KRISTINE HOLMES DIRECTOR 1.0 0.0 X 0 0 0 DAVID BERRY DIRECTOR - TERMED 2/2014 1.0 0.0 X 0 0 0 STEVEN MEANS DIRECTOR 1.0 0.0 X 0 0 0 MICHELLE WALKER CLINICAL NURSE MANAGER 40.0 0.0 X 102873 0 39092 KAREN SCHLAGETER CLINICAL NURSE MANAGER 40.0 0.0 X 107665 0 40913 366920 0 139430 3 false true true FOUNDATION MEDICAL STAFFING 416 WEST 15TH STREET BLDG 600 EDMOND OK 73013 TEMP STAFFING SRVCS 570054 FRESENIUS MEDICAL CARE 920 WINTER STREET WALTHAM MA 024511457 MED SUPPLIES/PRODUCT 920150 JH FINDORFF SON INC 300 S BEDFORD STREET MADISON WI 53703 CONSTRUCTION 811895 FINDORFF INC PO BOX 575 MADISON WI 53701 CONSTRUCTION 285263 NXSTAGE MEDICAL INC 350 MERRIMACK STREET LAWRENCE MA 01843 MED SUPPLIES/PRODUCT 192554 10 X 2441 2441 INPATIENT REVENUE 621990 241083 241083 OUTPATIENT REVENUE 621400 12597824 12597824 12838907 2849 2849 0 0 34574 0 34574 0 34574 34574 0 0 0 0 0 12878771 12838907 37423 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 0 0 10340 0 10340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76115 69410 6705 0 45556 2691 42865 0 0 0 0 0 355774 296968 58806 0 23009 14497 8512 0 0 0 0 0 13412 7898 5514 0 0 0 0 0 0 0 0 0 174369 174369 0 0 38396 38396 0 0 CONTRACT WAGE/BENEFITS/TAXES 5347716 4334180 1013536 0 PHARMACEUTICALS 1534327 1473331 60996 0 MEDICAL SUPP/PURCH SVCS 2192015 2011651 180364 0 PROFESSIONAL SERVICES 373162 234527 138635 0 258973 243389 15584 10443164 8901307 1541857 0 X 6854124 6883440 0 0 0 0 1261439 1777208 0 0 0 0 0 0 0 0 55831 32284 3456271 1656600 398270 1799671 0 0 0 0 0 0 0 0 210158 0 8779822 10492603 21820 23290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1088190 363894 1110010 387184 X 7669812 10105419 0 0 0 0 7669812 10105419 8779822 10492603 2435607 X false true X true false X X false false false MERITER HOSPITAL INC 390806367 03 true false true 0 UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY 391835630 03 true false true 0 UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC 391824445 09 true false true 0 3 0 2154170 660841 1493329 1302101 995759 306342 1799671 0 ACCRUED LIABILITY TO UWHC 320225 UNEARNED INCOME 43669 363894 X 12878771 12878771 12878771 10443164 10443164 10443164 SCHEDULE D, PART X: FIN 48 - LIABILITY FOR UNCERTAIN TAX POSITIONS: The organization's income tax filings are subject to audit by various taxing authorities. Open periods subject to audit for federal and Wisconsin purposes are generally the previous three and four years of tax returns filed, respectively. There were no interest or penalties recorded for the year ended June 30, 2014. JOHN J HENSEY SEC.&ADMIN DIR.-TERMED 1/2014 148935 0 7447 0 0 0 59425 0 0 0 215807 0 0 0 MICHELLE WALKER CLINICAL NURSE MANAGER 97974 0 4899 0 0 0 39092 0 0 0 141965 0 0 0 KAREN SCHLAGETER CLINICAL NURSE MANAGER 107665 0 0 0 0 0 40913 0 0 0 148578 0 0 0 FORM 990, SCHEDULE J, PART III COMPENSATION RECEIVED FROM UNRELATED ORGANIZATION: THE INDIVIDUALS LISTED IN SCHEDULE J, PART II, RECEIVED COMPENSATION FROM THE UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY, AN UNRELATED ORGANIZATION, FOR SERVICES RENDERED TO THE ORGANIZATION IN THE INDIVIDUALS' CAPACITY AS AN OFFICER AND EMPLOYEES OF THE ORGANIZATION. PART VI, LINE 7A ELECTION OF MEMBERS OF THE GOVERNING BODY: THE CEO OF THE THREE MEMBER OWNERS HAS THE RIGHT TO ASSIGN HIS/HER REPRESENTATIVES FROM HIS/HER ORGANIZATION TO SERVE AS MEMBERS OF THE WDI BOARD OF DIRECTORS. PART VI, LINE 11B REVIEW OF FORM 990 BY THE ORGANIZATION'S GOVERNING BODY: A copy of the Form 990 is emailed as an attachment to each board member during a brief comment period before it is filed with the IRS. PART VI, LINE 12C MONITORING AND ENFORCING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY: To ensure that the ORGANIZATION operates in a manner consistent with its charitable purposes and that it does not engage in activities that could jeopardize its status as an organization exempt from federal income tax, periodic reviews shall be conducted. The periodic reviews shall, at a minimum, include the following subjects to the extent such subjects are applicable: 1. Whether compensation arrangements and benefits are reasonable and are the result of arm's length bargaining. 2. Whether acquisitions of physician practices and other provider services result in inurement or impermissible private benefit. 3. Whether partnership and joint venture arrangements and arrangements with management service organizations and physician hospital organizations conform to written policies, are properly recorded, reflect reasonable payments for goods and services, further the ORGANIZATION's charitable purposes and do not result in inurement or impermissible private benefit. 4. Whether agreements to provide health care and agreements with other health care providers, employees, and third party payors further the Corporation's charitable purposes and do not result in inurement or impermissible private benefit. 5. The policy covers all voting and ex-officio board members. Anyone found to be in violation of this policy would be recused from voting on and discussion about the transaction or topic. All review activity of actual or potential conflicts takes place at the full board level. PART VI, LINE 19 AVAILABILITY OF ORGANIZATION DOCUMENTS: All referenced documents are available to the public upon request. PART VI, LINE 3 DELEGATION OF CONTROL OVER MANAGEMENT DUTIES: Wisconsin Dialysis, INC.'S Board Secretary FUNCTIONS AS THE ORGANIZATION'S administrative director AND COMPENSATION IS PAID BY AN UNRELATED ORGANIZATION, UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY (UWHC). All management duties are provided FOR under a Management Services Agreement BETWEEN WDI AND UWHC. Hospital and Clinics. PART VI, LINE 6 MEMBERS OF THE ORGANIZATION Members are all of one class with 45% ownership by Meriter Hospital, 45% owned by Univ. of WI Hospital and Clinics, and 10% owned by Univ. of WI Medical Foundation. PART VII, LINE 1D, LINE 2 AND LINE 4 COMPENSATION FROM ORGANIZATION: THE COMPENSATION REPORTED IN PART VII, LINE 1D, LINE 2 AND LINE 4 HAS BEEN RECEIVED FROM UNIVERSITY OF HOSPITALS AND CLINICS AUTHORITY (UWHC), AN UNRELATED ORGANIZATION, FOR SERVICES RENDERED TO THE ORGANIZATION IN THE INDIVIDUALS' CAPACITIES AS OFFICERS OR EMPLOYEES OF THE ORGANIZATION.