HOLY FAMILY MEMORIAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- HOLY FAMILY MEMORIAL INC (EIN 39-0806395)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-14
- IRS object ID
- 201433189349309203
- Schema version
- 2013v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-14T16:52:27-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 391173131 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCHENCK SC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 MARITIME DRIVE SUITE 2B | AddressLine1 |
| City | MANITOWOC | City |
| State | WI | State |
| ZIP Code | 54220 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390806395 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLY FAMILY MEMORIAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOLY | BusinessNameControlTxt |
| Phone | 9203202011 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2300 WESTERN AVE PO BOX 1450 | AddressLine1 |
| City | MANITOWOC | City |
| State | WI | State |
| ZIP Code | 542211450 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK HERZOG | PersonNm |
| Person Title | PRESIDENT / CEO | PersonTitleTxt |
| Phone | 9203203470 | PhoneNum |
| Signature | 2014-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KELLY BLOCK CPA | PreparerPersonNm |
| PTIN | P00199509 | PTIN |
| Phone | 9206845500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK HERZOG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2300 WESTERN AVE PO BOX 1450 | AddressLine1 |
| City | MANITOWOC | City |
| State | WI | State |
| ZIP Code | 542211450 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $138,622,352 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HFMHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1899 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | HEALTH CARE SERVICESSEE SCHEDULE O HOLY FAMILY MEMORIAL IS A NETWORK OF HEALTH PROFESSIONALS WHO, ROOTED IN THE HEALING MINISTRY OF JESUS CHRIST, PROVIDE SERVICES TO HELP INDIVIDUALS AND OUR COMMUNITIES ACHIEVE HEALTHIER LIVES. HFM PROVIDES ACUTE, OUTPATIENT, CLINIC, HOME CARE AND HOSPICE SERVICES FOR MANITOWOC COUNTY, STRIVING FOR MEDICIAL EXCELLENCE AND VALUED OUTCOMES WITHIN A COMPASSIONATE, VALUES BASED, CHRISTIAN ENVIRONMENT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 1269 | TotalEmployeeCnt |
| Total Volunteers | 330 | TotalVolunteersCnt |
| Total Gross UBI | -$248,066 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$20,625 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $760,996 | PYContributionsGrantsAmt |
| CY Contributions Grants | $596,002 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $126,777,153 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $132,958,817 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,731,265 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,202,328 | CYInvestmentIncomeAmt |
| PY Other Revenue | $224,576 | PYOtherRevenueAmt |
| CY Other Revenue | $179,589 | CYOtherRevenueAmt |
| PY Total Revenue | $129,493,990 | PYTotalRevenueAmt |
| CY Total Revenue | $136,936,736 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $44,350 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $65,719 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $78,476,976 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $78,978,708 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $210,770 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $48,878,691 | PYOtherExpensesAmt |
| CY Other Expenses | $53,410,505 | CYOtherExpensesAmt |
| PY Total Expenses | $127,400,017 | PYTotalExpensesAmt |
| CY Total Expenses | $132,454,932 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,093,973 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,481,804 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $170,044,589 | TotalAssetsBOYAmt |
| Total Assets EOY | $176,647,204 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $65,733,371 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $64,072,941 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $104,311,218 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $112,574,263 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | HOLY FAMILY MEMORIAL IS A NETWORK OF HEALTH PROFESSIONALS WHO, ROOTED IN THE HEALING MINISTRY OF JESUS CHRIST, PROVIDE SERVICES TO HELP INDIVIDUALS AND OUR COMMUNITIES ACHIEVE HEALTHIER LIVES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $120,029,634 | ExpenseAmt |
| Grant | $65,719 | GrantAmt |
| Revenue | $136,841,923 | RevenueAmt |
| Desc | HOLY FAMILY MEMORIAL IS AN INTEGRATED NETWORK PROVIDING HEALTH CARE SERVICES INTENDED TO BENEFIT THE HEALTH AND WELLBEING OF THE COMMUNITIES IT SERVES. THESE SERVICES INCLUDE PRIMARY AND SPECIALTY CLINIC CARE, PREVENTIVE CARE SUCH AS HEALTH SCREENINGS, VACCINATION CLINICS AND HEALTH EDUCATION CLASSES, 24/7 EMERGENCY CARE, WALK-IN, INPATIENT ACUTE CARE, OUTPATIENT CARE, HOME CARE AND HOSPICE, HOME MEDICAL EQUIPMENT, PRESCRIPTIONS, OCCUPATIONAL HEALTH SERVICES, AND MEDICALLY BASED FITNESS AND WELLNESS. HOLY FAMILY MEMORIAL HAS BEEN ABLE TO ACHIEVE A GREATER IMPACT IN THE COMMUNITY BY PARTNERING FINANCIAL, HUMAN AND PROGRAMMATIC RESOURCES WITH OTHER ORGANIZATIONS. (CONTINUED ON SCHEDULE O)THESE PARTNERSHIPS INCLUDE A COMMITMENT TO COLLABORATE WITH OTHER HEALTH AND SOCIAL SERVICE AGENCIES TO IMPROVE ACCESS TO CARE, FOCUS ON PREVENTIVE SERVICES, REDUCE COMMUNITY HEALTH RISKS AND CONTRIBUTE TO A HEALTHIER, VIBRANT COMMUNITY.HOLY FAMILY MEMORIAL PROVIDES MEDICALLY NECESSARY SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICIES. IN ASSESSING A PATIENT'S ABILITY TO PAY, HOLY FAMILY MEMORIAL UTILIZES GENERALLY RECOGNIZED POVERTY INCOME LEVELS OF THE COMMUNITIES IT SERVES AND CONSIDERS SITUATIONS WHERE INCURRED CHARGES ARE SIGNIFICANT WHEN COMPARED TO THE PATIENT'S FINANCIAL RESOURCES. BECAUSE HOLY FAMILY MEMORIAL DOES NOT EXPECT TO RECEIVE PAYMENT OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT INCLUDED IN NET PATIENT SERVICE REVENUES. HOLY FAMILY MEMORIAL'S TOTAL COMMUNITY BENEFIT INCLUDES THE COST OF CHARITY CARE AND UNPAID COST OF PUBLIC PROGRAMS (MEDICARE AND MEDICAID) AS WELL AS THOSE DISCUSSED ABOVE. HOLY FAMILY MEMORIAL'S COMMUNITY BENEFIT WAS APPROXIMATELY $24,527,000 FOR THE YEAR ENDED DECEMBER 2013. THIS AMOUNT INCLUDES THE NET COST OF CHARITY CARE OF APPROXIMATELY $1,774,920. MORE INFORMATION AVAILABLE FROM OUR COMMUNITY BENEFIT REPORT WHICH CAN BE LOCATED ON OUR WEBSITE AT WWW.HFMHEALTH.ORG. | Desc |
| Total Program Service Expenses | $120,029,634 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 32 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1269 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | 0 | Form8899Filedind |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| Excess Business Holdings | 0 | ExcessBusinessHoldingsInd |
| Taxable Distributions | 0 | TaxableDistributionsInd |
| Distribution To Donor | 0 | DistributionToDonorInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARK HERZOG PRESIDENT CEO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9203203470 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2300 WESTERN AVENUE | AddressLine1 |
| City | MANITOWOC | City |
| State | WI | State |
| ZIP Code | 542211450 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| RYAN M DOPIRAK MD | ||||||||
| PHYSICIAN COUNCIL CHAIR | 40.00 | Yes (X) | $1,492,021 | $0 | $32,898 | |||
| MATTHEW L CAMPBELL MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $331,984 | $0 | $30,294 | |||
| WILLIAM D HAMPTON MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $307,649 | $0 | $30,499 | |||
| PRADEEP GIRIYAPPA MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $257,837 | $0 | $24,302 | |||
| MARY A GOVIER MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $178,534 | $0 | $32,565 | |||
| DEREK R BOWN DC | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $120,749 | $0 | $28,097 | |||
| DONALD R BRISCH | ||||||||
| DIRECTOR/TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| WILLIAM R CASEY | ||||||||
| TREASURER/CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| WILLIAM C CENSKY | ||||||||
| CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| LAURIE CRAWFORD | ||||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JEFFREY S DUNN | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SISTER LORITA M GAFFNEY | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MARILYN KAUFMANN | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| LEE H KUMMER | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SISTER MARY ANN NUGENT | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JANE L PFEFFER | ||||||||
| VICE CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MARK SWANSON | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SISTER ELAINE TURBA | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SISTER PAULA VANDEN HOGEN | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SISTER JAN VILLEMURE | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHLEEN A ZUCCHI | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SISTER LAURA WOLF | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK P HERZOG | ||||||||
| DIRECTOR, PRESIDENT, CEO | 40.00 | Yes (X) | $513,429 | $0 | $94,944 | Yes (X) | ||
| PATRICIA HUETTL | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | $280,959 | $0 | $69,239 | Yes (X) | |||
| STEVEN D DRIGGERS MD | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | $633,237 | $0 | $94,781 | Yes (X) | |||
| MARY MAURER | ||||||||
| CHIEF INNOVATION OFFICER | 40.00 | $221,434 | $0 | $32,924 | Yes (X) | |||
| KIRK DIMITRIS MD | ||||||||
| PHYSICIAN | 40.00 | $1,428,538 | $0 | $27,691 | Yes (X) | |||
| DAVID MIKOLYZK MD | ||||||||
| PHYSICIAN | 40.00 | $869,849 | $0 | $32,572 | Yes (X) | |||
| CHARLES L LAHAM MD | ||||||||
| PHYSICIAN | 40.00 | $534,324 | $0 | $33,106 | Yes (X) | |||
| NANCY N BUTLER MD | ||||||||
| PHYSICIAN | 40.00 | $673,591 | $0 | $14,191 | Yes (X) | |||
| JEFFREY A JACOBY MD | ||||||||
| PHYSICIAN | 40.00 | $1,192,377 | $0 | $26,448 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $9,036,512 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $604,551 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 88 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CARETECH SOLUTIONS | |||||
| 901 WILSHIRE DRIVE STE 250 | TROY | MI | 48084 | IT SERVICES | $5,453,746 |
| COMPLETERX LTD | |||||
| 3100 S GESSNER STE 640 | HOUSTON | TX | 77063 | PHARMACY SERVICES | $2,871,805 |
| PATRIOT MEDICAL TECH | |||||
| PO BOX 415000 | NASHVILLE | TN | 372415000 | BIO-MED SERVICES | $1,177,752 |
| RADIATION ONCOLOGY SPECIALISTS | |||||
| PO BOX 678 | STURGEON BAY | WI | 54235 | CANCER CARE SERVICES | $594,931 |
| ST VINCENT HOSPITAL | |||||
| PO BOX 13508 | GREEN BAY | WI | 543073508 | LINEN SERVICES | $547,783 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $36,241 | FundraisingAmt |
| Government Grants | $123,264 | GovernmentGrantsAmt |
| All Other Contributions | $436,497 | AllOtherContributionsAmt |
| Noncash Contributions | $8,500 | NoncashContributionsAmt |
| Total Contributions | $596,002 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| INTEGRATED HEALTH CARE | 900099 | $115,941,557 | $115,941,557 | |
| LAB | 621500 | $10,955,627 | $10,932,927 | $22,700 |
| PHARMACY | 446110 | $6,061,633 | $6,061,633 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $132,958,817 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,563,091 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,563,091 | RelatedOrExemptFuncIncomeAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $342,683 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $320,856 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $21,827 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,827 | TotalRevenueColumnAmt |
| Exclusion | $21,827 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $838,202 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,198,965 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$360,763 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$360,763 | TotalRevenueColumnAmt |
| Exclusion | -$360,763 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $111,660 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $36,241 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $26,875 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $84,785 | TotalRevenueColumnAmt |
| Exclusion | $84,785 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $4,090 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $3,062 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,028 | TotalRevenueColumnAmt |
| Exclusion | $1,028 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $171,071 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $135,858 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,213 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $35,213 | UnrelatedBusinessRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| INVESTMENT HFHS & DME | 446110 | $165,304 | $165,304 | |
| MISCELLANEOUS | 900003 | -$128,568 | $177,411 | -$305,979 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $36,736 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $136,936,736 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $136,841,923 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$248,066 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$253,123 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,719 | TotalAmt |
| Program Services | $65,719 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,828,158 | TotalAmt |
| Program Services | $2,879,519 | ProgramServicesAmt |
| Management And General | $1,948,639 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,786,331 | TotalAmt |
| Program Services | $56,349,475 | ProgramServicesAmt |
| Management And General | $4,321,235 | ManagementAndGeneralAmt |
| Fundraising | $115,621 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $769,664 | TotalAmt |
| Program Services | $712,192 | ProgramServicesAmt |
| Management And General | $55,882 | ManagementAndGeneralAmt |
| Fundraising | $1,590 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,057,322 | TotalAmt |
| Program Services | $8,613,351 | ProgramServicesAmt |
| Management And General | $405,519 | ManagementAndGeneralAmt |
| Fundraising | $38,452 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,537,233 | TotalAmt |
| Program Services | $3,222,445 | ProgramServicesAmt |
| Management And General | $307,015 | ManagementAndGeneralAmt |
| Fundraising | $7,773 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $758,373 | TotalAmt |
| Program Services | $93,717 | ProgramServicesAmt |
| Management And General | $664,656 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,000 | TotalAmt |
| Management And General | $147,000 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,416 | TotalAmt |
| Management And General | $118,416 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,470,188 | TotalAmt |
| Program Services | $1,470,188 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $637,368 | TotalAmt |
| Program Services | $70,190 | ProgramServicesAmt |
| Management And General | $567,178 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $522,744 | TotalAmt |
| Program Services | $415,848 | ProgramServicesAmt |
| Management And General | $100,205 | ManagementAndGeneralAmt |
| Fundraising | $6,691 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,134,907 | TotalAmt |
| Program Services | $5,134,907 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,496,853 | TotalAmt |
| Program Services | $1,549,530 | ProgramServicesAmt |
| Management And General | $915,679 | ManagementAndGeneralAmt |
| Fundraising | $31,644 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $411,190 | TotalAmt |
| Program Services | $254,694 | ProgramServicesAmt |
| Management And General | $156,073 | ManagementAndGeneralAmt |
| Fundraising | $423 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $347,988 | TotalAmt |
| Program Services | $214,782 | ProgramServicesAmt |
| Management And General | $133,206 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,159,704 | TotalAmt |
| Program Services | $2,159,704 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,561,019 | TotalAmt |
| Program Services | $7,404,291 | ProgramServicesAmt |
| Management And General | $154,647 | ManagementAndGeneralAmt |
| Fundraising | $2,081 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $851,312 | TotalAmt |
| Program Services | $849,785 | ProgramServicesAmt |
| Management And General | $1,527 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL/SURGICAL SUPPLI | $16,035,078 | $16,035,078 | ||
| PURCHASED SERVICES | $6,634,890 | $4,610,963 | $2,017,716 | $6,211 |
| MAINTENANCE | $3,312,274 | $3,271,621 | $40,653 | |
| STATE PROVIDER ASSESSME | $2,990,864 | $2,990,864 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,820,337 | TotalAmt |
| Program Services | $1,660,771 | ProgramServicesAmt |
| Management And General | $159,282 | ManagementAndGeneralAmt |
| Fundraising | $284 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $132,454,932 | TotalAmt |
| Program Services | $120,029,634 | ProgramServicesAmt |
| Management And General | $12,214,528 | ManagementAndGeneralAmt |
| Fundraising | $210,770 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Joint Costs | Yes (X) | JointCostsInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,487,108 | BOYAmt |
| EOY | $8,531,070 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,911,962 | BOYAmt |
| EOY | $4,555,671 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,269 | BOYAmt |
| EOY | $20,269 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,598,147 | BOYAmt |
| EOY | $21,930,752 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $300,000 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,945,539 | BOYAmt |
| EOY | $2,251,697 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,130,142 | BOYAmt |
| EOY | $7,393,728 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $178,144,283 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $111,675,054 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,275,651 | BOYAmt |
| EOY | $66,469,229 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,883,872 | BOYAmt |
| EOY | $41,497,975 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,549,808 | BOYAmt |
| EOY | $19,892,686 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,814,204 | BOYAmt |
| EOY | $3,381,711 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $427,887 | BOYAmt |
| EOY | $422,416 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,044,589 | BOYAmt |
| EOY | $176,647,204 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,673,022 | BOYAmt |
| EOY | $14,813,355 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,660 | BOYAmt |
| EOY | $30,639 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,602,802 | BOYAmt |
| EOY | $48,806,531 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $427,887 | BOYAmt |
| EOY | $422,416 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,733,371 | BOYAmt |
| EOY | $64,072,941 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,395,650 | BOYAmt |
| EOY | $110,297,499 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $273,086 | BOYAmt |
| EOY | $350,024 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,642,482 | BOYAmt |
| EOY | $1,926,740 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,311,218 | BOYAmt |
| EOY | $112,574,263 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,044,589 | BOYAmt |
| EOY | $176,647,204 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,481,804 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $3,599,242 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $181,999 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $1,700 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $12,640 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $14,340 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | PART II-B, LINES 1B & 1G: HOLY FAMILY MEMORIAL SENT A REPRESENTATIVE TO WASHINGTON DC ONCE TO DISCUSS SPECIFIC LEGISLATIVE MATTERS WITH THEIR FEDERAL REPRESENTATIVES. HFM ALSO ATTENDED ONE DAY WHERE A SMALL NUMBER OF STAFF VISITED THE CAPITAL TO EDUCATE THEIR LEGISLATORS ON VARIOUS HEALTHCARE TOPICS. PART II-B, LINE 1I, OTHER ACTIVITIES: HOLY FAMILY MEMORIAL BELONGS TO HOSPITAL ASSOCIATIONS WHICH USE A PERCENTAGE OF THE DUES FOR LOBBYING PURPOSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,915,567 | BeginningYearBalanceAmt |
| Contributions | $374,287 | ContributionsAmt |
| Investment Earnings Or Losses | $179,201 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $192,292 | OtherExpendituresAmt |
| End Year Balance | $2,276,763 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,637,918 | BeginningYearBalanceAmt |
| Contributions | $514,026 | ContributionsAmt |
| Other Expenditures | $236,377 | OtherExpendituresAmt |
| End Year Balance | $1,915,567 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,602,667 | BeginningYearBalanceAmt |
| Contributions | $202,680 | ContributionsAmt |
| Investment Earnings Or Losses | -$9,775 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $500 | GrantsOrScholarshipsAmt |
| Other Expenditures | $157,154 | OtherExpendituresAmt |
| End Year Balance | $1,637,918 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,429,395 | BeginningYearBalanceAmt |
| Contributions | $240,013 | ContributionsAmt |
| Investment Earnings Or Losses | $162,063 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $500 | GrantsOrScholarshipsAmt |
| Other Expenditures | $228,304 | OtherExpendituresAmt |
| End Year Balance | $1,602,667 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,223,863 | BeginningYearBalanceAmt |
| Contributions | $485,645 | ContributionsAmt |
| Investment Earnings Or Losses | -$107,593 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $500 | GrantsOrScholarshipsAmt |
| Other Expenditures | $172,020 | OtherExpendituresAmt |
| End Year Balance | $1,429,395 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.93000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.07000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,863,318 | OtherCostOrOtherBasisAmt |
| Book Value | $4,863,318 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $107,643,909 | OtherCostOrOtherBasisAmt |
| Depreciation | $62,277,697 | DepreciationAmt |
| Book Value | $45,366,212 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,207,634 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,634,208 | DepreciationAmt |
| Book Value | $573,426 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $58,500,692 | OtherCostOrOtherBasisAmt |
| Depreciation | $43,968,868 | DepreciationAmt |
| Book Value | $14,531,824 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,928,730 | OtherCostOrOtherBasisAmt |
| Depreciation | $794,281 | DepreciationAmt |
| Book Value | $1,134,449 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $66,469,229 | TotalBookValueLandBuildingsAmt |
Financial Derivatives FinancialDerivativesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $19,892,686 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $19,892,686 | TotalBookValueSecuritiesAmt |
| Total Rev Etc Audited Fincl Stmt | $140,356,765 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $3,420,041 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$12 | OtherRevenueAmt |
| Revenue Not Reported | $3,420,029 | RevenueNotReportedAmt |
| Revenue Subtotal | $136,936,736 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $136,936,736 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $132,454,918 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$14 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$14 | ExpensesNotReportedAmt |
| Expenses Subtotal | $132,454,932 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $132,454,932 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | HOLY FAMILY MEMORIAL'S ENDOWMENT FUNDS WERE ESTABLISHED TO PROVIDE FINANCIAL SUPPORT ON AN ONGOING BASIS TO MEET THE CURRENT AND FUTURE NEEDS OF HOLY FAMILY MEMORIAL AND THE PEOPLE IT SERVES. FUNDS ARE USED FOR CAPITAL EQUIPMENT, MAJOR BUILDING IMPROVEMENTS, PROGRAM DEVELOPMENT, AND OPERATIONS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | ROUNDING -12. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | ROUNDING -14. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | SAMARITAN DAY | NameOfEvent1Amt |
| Gross Receipts Event1 | $84,257 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $30,744 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $53,513 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $16,815 | OtherDirectExpensesEvent1Amt |
| Name Of Event2 | SAMARITAN DAY | NameOfEvent2Amt |
| Gross Receipts Event2 | $26,210 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $53 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $26,157 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $3,542 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 3 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $37,434 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $5,444 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $31,990 | GrossRevenueOtherEventsAmt |
| Food And Beverage Other Events | $6,518 | FoodAndBeverageOtherEventsAmt |
| Gross Receipts Total | $147,901 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $36,241 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $111,660 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $6,518 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $20,357 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $26,875 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $84,785 | NetIncomeSummaryAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed | Yes (1) | LicensedInd |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1717 | PersonsServedCnt |
| Total Community Benefit Expns | $1,774,920 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,774,920 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01340 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 34592 | PersonsServedCnt |
| Total Community Benefit Expns | $12,595,055 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,120,635 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,474,420 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06400 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 36309 | PersonsServedCnt |
| Total Community Benefit Expns | $14,369,975 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,120,635 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,249,340 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07740 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 8445 | PersonsServedCnt |
| Total Community Benefit Expns | $108,693 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $108,693 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 599 | PersonsServedCnt |
| Total Community Benefit Expns | $358,971 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $358,971 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 38 | PersonsServedCnt |
| Total Community Benefit Expns | $88,287 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $45,845 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $42,442 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 535 | PersonsServedCnt |
| Total Community Benefit Expns | $149,904 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $149,904 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 9617 | PersonsServedCnt |
| Total Community Benefit Expns | $705,855 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $45,845 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $660,010 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00490 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 45926 | PersonsServedCnt |
| Total Community Benefit Expns | $15,075,830 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,166,480 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,909,350 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08230 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,498 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,498 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 15 | PersonsServedCnt |
| Total Community Benefit Expns | $1,671 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,671 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,708 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,708 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $921 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $921 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1722 | PersonsServedCnt |
| Total Community Benefit Expns | $3,241 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,241 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1737 | PersonsServedCnt |
| Total Community Benefit Expns | $25,039 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,039 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,753,647 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $370,183 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $44,424,174 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $58,021,761 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$13,597,587 | 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 (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 YORK STREET PROPERTIES LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | REAL ESTATE | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.36000 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.00000 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.00000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | HOLY FAMILY MEMORIAL INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2300 WESTERN AVE PO BOX 1450 | AddressLine1 |
| City | MANITOWOC | City |
| State | WI | State |
| ZIP Code | 542211450 | 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 |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLY FAMILY MEMORIAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | 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 |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.HFMHEALTH.ORG | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | FACEBOOK - HOLY FAMILY MEMORIAL; HEALTHIESTMC. | OtherWebsiteURLTxt |
| 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 | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| HOLY FAMILY MEMORIAL INC | PART V, SECTION B, LINE 4: ASSESSMENT WAS COMPLETED WITH A FORMAL COMMUNITY GROUP WITH MEMBERSHIP TO INCLUDE AURORA MEDICAL CENTER, TWO RIVERS. |
| HOLY FAMILY MEMORIAL INC | PART V, SECTION B, LINE 14G: HOLY FAMILY MEMORIAL'S COMMUNITY CARE PROGRAM IS COMMUNICATED ON THE WEBSITE SUMMARIZING THE ELIGIBILITY REQUIREMENTS TO INCLUDE SERVICES COVERED, INCOME GUIDELINES, APPLICATION FORM, AND OTHER DOCUMENTS NEEDED FOR COMPLETION OF THE APPLICATION. THE COMMUNITY CARE PROGRAM IS ALSO COMMUNICATED VIA PAYMENT GUIDELINE BROCHURES AVAILABLE IN THE REGISTRATION AREAS AT ALL HFM LOCATIONS THROUGHOUT THE COMMUNITY, AND TO PATIENTS IN COMMUNICATION WITH PRICE ESTIMATIONS AND COLLECTIONS, BOTH VERBAL AND WRITTEN. THE POLICY IS ALSO AVAILABLE UPON REQUEST. |
| HOLY FAMILY MEMORIAL INC | PART V, SECTION B, LINE 18E: PAYMENT GUIDELINES AND FINANCIAL ASSISTANCE POLICY IS POSTED IN PATIENT ROOMS AND LOBBIES, ADMISSION/REGISTRATION AREAS, GIVEN TO ALL SURGERY PATIENTS, AND PUBLISHED ON THE BACK OF ALL PATIENT STATEMENTS. |
| HOLY FAMILY MEMORIAL INC | PART V, SECTION B, LINE 20D: THE HOSPITAL FACILITY USED THE AVERAGE OF ITS FIVE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| HOLY FAMILY HEALTH SERVICES INC | ||||
| 3310 CALUMET AVENUE | MANITOWOC | WI | 54220 | RETAIL PHARMACY |
| NORTH END HOME MEDICAL SERVICES LLC | ||||
| 3310 CALUMET AVENUE | MANITOWOC | WI | 54220 | DURABLE MEDICAL EQUIPMENT |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | COMMUNITY BENEFITS ARE PROGRAMS OR ACTIVITIES THAT PROVIDE CARE AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. HOLY FAMILY MEMORIAL'S COMMUNITY BENEFIT PROGRAMS INCLUDE SERVICES FOR THOSE WHO CAN NOT AFFORD HEALTH CARE AND INITIATIVES FOR IMPROVING HEALTH IN THE BROADER COMMUNITY. PROVIDING COMMUNITY BENEFITS DEMONSTRATES THAT HOLY FAMILY MEMORIAL IS FULFILLING ITS CHARITABLE MISSION AND DEMONSTRATING ITS PREFERENTIAL TAX STATUS IS DESERVED. |
| SCHEDULE H, PART I, LINE 7, COLUMN F | PERCENTAGE OF COMMUNITY BENEFIT EXPENSE TO OVERALL ENTITY'S EXPENSES. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | COMMUNITY BUILDING ACTIVITIES INDICATED IN PART II PROMOTE THE HEALTH OF THE MANITOWOC COMMUNITY BY ACTIVELY ADDRESSING EXPRESSED AND REPORTED ISSUES. SPECIFICALLY, THROUGH THE PROGRAMS INDICATED, HOLY FAMILY MEMORIAL AND IN PARTNERSHIP WITH OTHERS, WORKS DILIGENTLY TO ACHIEVE AN OVERALL HEALTHIER COMMUNITY. MAJOR INITIATIVES WITH POSITIVE RESULTS INCLUDE: IMPROVED ACCESS TO HEALTH CARE, IMPROVED MENTAL HEALTH ACCESS AND CARE, INCREASED EXERCISE FOR ADULTS AND CHILDREN, HEALTHY FOOD OPTIONS IN SCHOOLS, AND ACCESS TO FRESH FRUITS AND VEGETABLES FOR THE POOR. |
| PART III, LINE 4: | AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE ORGANIZATION'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. |
| PART III, LINE 8: | HOLY FAMILY MEMORIAL IS A LICENSED MEDICARE PROVIDER WITH APPROXIMATLEY 47 PERCENT OF ITS PATIENT BASE QUALIFYING FOR THIS PROGRAM. AT PRESENT, THE REIMBURSEMENT RATE FOR THE MEDICARE PROGRAM DOES NOT FULLY COVER THE COST OF CARE TO THESE PATIENTS. THIS REPRESENTS THE ESTIMATED SHORTFALL CREATED WHEN HOLY FAMILY MEMORIAL RECEIVES PAYMENTS BELOW THE COSTS OF TREATING MEDICARE AND OTHER PUBLIC PROGRAM BENEFICIARIES.COST METHODOLOGY = COST TO CHARGE RATIO |
| PART III, LINE 9B: | PAYMENT OPTIONS AS WELL AS COMMUNITY CARE ASSISTANCE IS NOTED ON ALL COLLECTION LETTERS, AS WELL AS INSURANCE BENEFIT PAPERWORK THAT IS SENT TO PATIENTS FOR INPATIENT, SAME DAY SURGERY, MRI, CT SCAN, ER SERVICES. A PATIENT FINANCIAL ADVISOR AND/OR ELIGIBILITY SPECIALIST SEES SELF-PAY INPATIENTS TO INTERVIEW & ADVISE PATIENTS OF ANY PROGRAMS THEY MAY QUALIFY FOR INCLUDING, BUT NOT LIMITED TO MEDICAID, VETERANS ADMINISTRATION, OR OUR OWN CHARITY CARE PROGRAM. IF THEY MAY QUALIFY FOR MEDICAID OR VETERANS ADMINISTRATION, THE ELIGIBILITY SPECIALIST WILL HELP THEM COMPLETE THE APPLICATION PROCESS AND FOLLOW UP ON THEIR APPLICATION THROUGH TO APPROVAL/DISAPPROVAL. FOR THE NETWORK CHARITY PROGRAM, AN APPLICATION IS PROVIDED AND THE PATIENT IS INSTRUCTED ON WHOM TO CALL FOR ASSISTANCE IN APPLYING. WHEN CONTACTING PATIENTS BY PHONE, THE PATIENT FINANCIAL ADVISOR IS TRAINED TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR OUTSIDE STATE OR FEDERAL ASSISTANCE AND WILL DIRECT THOSE PATIENTS ON WHERE TO GO TO APPLY FOR THOSE PROGRAMS. THE ELIGIBILITY SPECIALIST WILL ASSIST AS WELL. |
| SCHEDULE H, PART III, LINE 3: | THROUGH ANALYTICAL TOOLS, A COLLECTION PREDICTION SCORE IS APPLIED TO ALL ACCOUNTS WRITTEN OFF TO BAD DEBT THROUGH A COLLECTION AGENCY. THOSE SCORING LOW/UNCOLLECTIBLE ARE ASSUMED CHARITY/COMMUNITY BENEFIT. |
| PART VI, LINE 2: | HOLY FAMILY MEMORIAL UTILIZES FOUR DISTINCT PROCESSES TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE. FIRST, AS A PART OF THE ANNUAL STRATEGIC PLANNING PROCESS, AN ENVIRONMENTAL ASSESSMENT IS DONE. INCLUDED IN THAT REPORT AND ANALYSIS IS CURRENT POPULATION DATA, COMMUNITY INPUT AND INPUT FROM VARIOUS CONSTITUENCIES RELATIVE TO PERCEIVED MET AND UNMET COMMUNITY HEALTH NEEDS. SECOND, HOLY FAMILY MEMORIAL PARTICIPATES IN A TRI-ANNUAL FULL COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IN PARTNERSHIP WITH HEALTHIEST MANITOWOC COUNTY, AURORA MEDICAL CENTER, MANITOWOC COUNTY PUBLIC HEALTH DEPT AND THE UNITED WAY. THIS ASSESSMENT CONSISTS OF INPUT OBTAINED FROM HUNDREDS OF COMMUNITY RESIDENTS, LEADERS, BUSINESSES; INCLUDING ALL AGE GROUPS, BEGINNING FROM HIGH SCHOOL AGE. THE INFORMATION IS TABULATED, ANALYZED AND UTILIZED TO DETERMINE PRIORITIZED HEALTH NEEDS. HOLY FAMILY MEMORIAL USES THIS INFORMATION IN ITS COMMUNITY IMPLEMENTATION PLAN. THIRD, HOLY FAMILY MEMORIAL CONDUCTS REGULAR INPUT SESSSIONS WITH LOCAL EMPLOYERS TO ASCERTAIN HEALTH NEEDS FROM AN OCCUPATIONAL HEALTH PERSPECTIVE. THIS INFORMATION IS THEN UTILIZED TO DEVELOP AND PROVIDE NEEDED EMPLOYER/EMPLOYEE HEALTH SERVICES THROUGHOUT THE BUSINESS COMMUNITY. LASTLY, HOLY FAMILY MEMORIAL UTILIZES A COMBINATION OF PATIENT FEEDBACK FROM ONGOING PATIENT SATISFACTION SURVEYS (CONDUCTED POST PROVISION OF SERVICES) AND COMMUNITY RESEARCH STUDIES COMMISSIONED BY HOLY FAMILY MEMORIAL, TO ASSESS PROGRAM AND SERVICE HEALTH CARE NEEDS OF THE COMMUNITY. |
| PART VI, LINE 3: | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE AREAS / WEBSITE / BROCHURES / ADMISSIONS STAFF / COLLECTION CORRESPONDENTS AS WELL AS INSURANCE BENEFIT PAPERWORK THAT IS SENT TO PATIENTS FOR INPATIENT, SAME DAY SURGERY, MRI, AND CT SCANS. A PATIENT FINANCIAL ADVISOR AND/OR ELIGIBILITY SPECIALIST SEES/COMMUNICATES TO SELF-PAY INPATIENTS TO INTERVIEW AND ADVISE PATIENT OF ANY PROGRAMS THEY MAY QUALIFY FOR INCLUDING, BUT NOT LIMITED TO MEDICAID, VETERANS ADMINISTRATION OR OUR OWN CHARITY PROGRAM. IF THEY QUALIFY FOR MEDICAID OR VETERANS ADMINISTRATION, WE ASSIST THEM IN COMPLETING THE APPLICATION AND FOLLOW UP ON THE APPLICATION THROUGH APPROVAL. FOR THE NETWORK CHARITY PROGRAM, AN APPLICATION IS PROVIDED AND THE PATIENT IS INSTRUCTED ON WHOM TO CALL FOR ASSISTANCE IN APPLYING. WHEN CONTACTING PATIENTS BY PHONE, THE PATIENT FINANCIAL ADVISOR OR ELIGIBILITY SPECIALIST IS TRAINED TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR OUTSIDE STATE OR FEDERAL ASSISTANCE AND WILL ASSIST THOSE PATIENTS ON APPLYING FOR THOSE PROGRAMS. |
| PART VI, LINE 4: | THE COMMUNITY THAT HOLY FAMILY MEMORIAL SERVICES IS CONSIDERED TO BE LOCATED IN THE RURAL LAKESHORE REGION OF NORTHEAST WISCONSIN. THE PRIMARY SERVICE AREA IS MANITOWOC COUNTY WITH SECONDARY NEIGHBORING COUNTIES; BROWN, KEWAUNEE, CALUMET AND SHEBOYGAN. SPECIFICALLY, THE COMMUNITY SERVED IS AN OLDER POPULATION WITH 18.1% OF THE PEOPLE AGE 65 OR OLDER WITH MEDIAN HOUSEHOLD INCOME OF APPROXIMATELY $50,000. 14.3% OF OUR SERVICES ARE DEDICATED TO PROVIDING CARE TO MEDICAID AND SELF-PAY PATIENTS. THE 2014 SERVICE AREA IS EXPECTED TO REMAIN AT 2013 LEVELS WITH A SLIGHT GROWTH TOWARD THE 65+ AGE AND RETRACTION OF THOSE 18-44. REFLECTIVE OF THIS NUMBER IS THAT OVER 47% OF OUR SERVICES ARE DEDICATED TO PROVIDING CARE TO MEDICARE PATIENTS. THE COMMUNITY IS MAINLY CAUCASIAN WITH SEVERAL OTHER NATIONALITIES INCLUDING AFRICAN AMERICAN, ASIAN AND HISPANIC. OTHER PROVIDERS IN THE AREA CONSIST OF THE AURORA MEDICAL GROUP, MANITOWOC SURGERY CENTER, AND SEVERAL OTHER INDEPENDENT PROVIDERS. |
| PART VI, LINE 5: | ALL OF HOLY FAMILY MEMORIAL'S BOARD MEMBERS RESIDE IN THE PRIMARY SERVICE AREA. THE BOARD CONSISTS OF COMMUNITY REPRESENTATIVES, PHYSICIANS AND REPRESENTATIVES OF THE SPONSOR ORGANIZATION. THE MEDICAL/DENTAL STAFF IS OPEN TO ALL QUALIFIED PROVIDERS WHO MEET THE REQUIREMENTS OF MEDICAL/DENTAL STAFF MEMBERSHIP. THE NETWORK OF PHYSICIANS AND OTHER PROVIDERS ARE COMMITTED TO PROVIDING EACH PATIENT WITH THE HIGHEST LEVEL OF PERSONAL CARE, RESPECT AND COMPASSION TO ENHANCE THE PATIENT'S QUALITY OF LIFE AND HEALTH STATUS. ALL SURPLUS FUNDS ARE REINVESTED IN THE ORGANIZATION TO PURCHASE NECESSARY MEDICAL EQUIPMENT, COMPENSATE EMPLOYEES, AND PLAN FOR FUTURE NEEDS. NONE OF THE SURPLUS EARNINGS BENEFIT ANY INDIVIDUALS OR OTHER CORPORATE ENTITIES. |
| PART VI, LINE 6: | THE HEALTH CARE NETWORK IS SPONSORED BY THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY, LOCATED AT HOLY FAMILY CONVENT, MANITOWOC, WISCONSIN. THE CONVENT, SITUATED ON SILVER LAKE, THREE MILES WEST OF LAKE MICHIGAN, IS HOME FOR OVER 350 CONGREGATION MEMBERS WHO SERVE THROUGHOUT THE UNITED STATES AND ARE PRIMARILY ENGAGED IN EDUCATION, PARISH AND HEALTH MINISTRIES. THE HEALTHCARE MINISTRY SPANS THREE STATES - WISCONSIN, NEBRASKA AND OHIO - AND HAS EXISTED FOR OVER 100 YEARS. THE MISSION OF THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY HEALTHCARE MINISTRY IS TO CARRY OUT THE COMMITMENT OF THE SPONSOR IN THE HEALING MISSION OF THE CATHOLIC CHURCH THROUGH THE PROVISION OF QUALITY HEALTHCARE SERVICES TO THE PEOPLE OF GOD IN OUR COMMUNITIES. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI,NE |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc |
|---|---|---|---|
| SCHOLARSHIPS | 11 | $13,400 | ACTUAL TUITION COST |
| SCHOLARSHIPS - EDUCATION | 15 | $38,300 | ACTUAL TUITION COST |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART III: | FormAndLineReferenceDesc |
| Explanation | HOLY FAMILY MEMORIAL'S SCHOLARSHIP PROGRAM IS DESIGNED AS A RECRUITMENT TOOL FOR EMPLOYMENT OF CANDIDATES IN SPECIFIED POSITIONS, CONSIDERED DIFFICULT TO FILL AND TO ASSIST STUDENTS IN THEIR PURSUIT OF A HEALTH CARE RELATED DEGREE. AREAS OF STUDY INCLUDE NURSING, PHARMACY, PHYSICAL THERAPY AND OTHERS. IN RETURN FOR THE SCHOLARSHIP, AN EMPLOYMENT SERVICE COMMITMENT IS MADE. IN ORDER TO BE ELIGIBLE: 1) STUDENTS MUST BE ACCEPTED INTO AN ACCREDITED PROGRAM 2) CANDIDATES MUST BE ATTENDING SCHOOL AS A FULL OR PART TIME STUDENT AND REMAIN IN THAT STATUS 3) STUDENTS MUST HAVE AND MAINTAIN A 3.0 CUMULATIVE GRADE POINT AVERAGE. SCHOLARSHIPS ARE AWARDED ON THE BASIS OF GRADE POINT AVERAGE, VERIFIED WITH OFFICIAL TRANSCRIPT OF GRADES, COMPLETION OF EMPLOYMENT APPLICATION AND PERSONAL INTERVIEW. THE SCHOLARSHIP IS USED FOR TUITION COST. THE SCHOLARSHIPS ARE GIVEN OUT EACH SEMESTER AND ARE PAID DIRECTLY TO THE SCHOOL THE STUDENT ATTENDS. APPLICANTS WHO ARE AWARDED THE SCHOLARSHIP MUST MAKE A SIX-MONTH COMMITMENT TO WORK AT HOLY FAMILY MEMORIAL FOR EACH SEMESTER THE SCHOLARSHIP IS AWARDED. THE SCHOLARSHIP RECIPIENT MUST REPAY THE FULL AMOUNT OF THE SCHOLARSHIP IF HE/SHE: 1) DROPS OUT OF SCHOOL 2) FALLS BELOW A 3.0 CUMULATIVE GRADE POINT AVERAGE 3) DOES NOT ACCEPT EMPLOYMENT 4) DOES NOT COMPLETE FULL LENGTH OF EMPLOYMENT COMMITMENT 5) DOES NOT OBTAIN WISCONSIN LICENSURE, AS REQUIRED. THE SCHOLARSHIP AWARD THROUGH EDUCATION ARE USED TO PROMOTE HEALTH CARE CAREERS. THE REQUIREMENTS FOR THE MEDICAL/DENTAL ENDOWMENT INCLUDE ACCEPTANCE AT AN ACCREDITED COLLEGE, UNIVERSITY, OR TECHNICAL SCHOOL, A MANITOWOC COUNTY RESIDENT, A GRADE POINT AVERAGE OF 3.0 OR ABOVE IS DESIRED, DEMONSTRATE HEALTH CAREER INTEREST AND FINANCIAL NEED. THESE SCHOLARSHIPS ARE OFFERED FOR ONE YEAR WITH POSSIBLE CONTINUATION BASED ON MEETING CRITERIA. THE CRITERIA FOR THE RONCALLI SCHOLARSHIP INCLUDES ACCEPTANCE AT AN ACCREDITED COLLEGE, UNIVERSITY, OR TECHNICAL SCHOOL, A MANITOWOC COUNTY RESIDENT, A GRADE POINT AVERAGE OF 3.0 OR ABOVE IS DESIRED, AND DEMONSTRATED HEALTH CAREER INTEREST. THESE SCHOLARSHIPS ARE PROVIDED FOR ONE YEAR. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RYAN M DOPIRAK MD | ||||||||||||||
| PHYSICIAN COUNCIL CHAIR | $688,278 | $0 | $743,203 | $0 | $60,540 | $0 | $5,646 | $0 | $29,502 | $0 | $1,527,169 | $0 | $0 | $0 |
| MATTHEW L CAMPBELL MD | ||||||||||||||
| DIRECTOR | $305,498 | $0 | $0 | $0 | $26,486 | $0 | $5,646 | $0 | $26,898 | $0 | $364,528 | $0 | $0 | $0 |
| WILLIAM D HAMPTON MD | ||||||||||||||
| DIRECTOR | $279,909 | $0 | $26,000 | $0 | $1,740 | $0 | $5,646 | $0 | $27,102 | $0 | $340,397 | $0 | $0 | $0 |
| PRADEEP GIRIYAPPA MD | ||||||||||||||
| DIRECTOR | $207,928 | $0 | $36,755 | $0 | $13,154 | $0 | $5,646 | $0 | $20,698 | $0 | $284,181 | $0 | $0 | $0 |
| MARY A GOVIER MD | ||||||||||||||
| DIRECTOR | $173,892 | $0 | $0 | $0 | $4,642 | $0 | $3,832 | $0 | $30,673 | $0 | $213,039 | $0 | $0 | $0 |
| MARK P HERZOG | ||||||||||||||
| DIRECTOR, PRESIDENT, CEO | $439,846 | $0 | $56,485 | $0 | $17,098 | $0 | $66,509 | $0 | $30,684 | $0 | $610,622 | $0 | $0 | $0 |
| PATRICIA HUETTL | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $218,976 | $0 | $20,372 | $0 | $41,611 | $0 | $39,456 | $0 | $31,953 | $0 | $352,368 | $0 | $37,228 | $0 |
| STEVEN D DRIGGERS MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $404,058 | $0 | $36,875 | $0 | $192,304 | $0 | $67,881 | $0 | $28,117 | $0 | $729,235 | $0 | $187,353 | $0 |
| MARY MAURER | ||||||||||||||
| CHIEF INNOVATION OFFICER | $194,266 | $0 | $17,464 | $0 | $9,704 | $0 | $29,776 | $0 | $5,204 | $0 | $256,414 | $0 | $0 | $0 |
| KIRK DIMITRIS MD | ||||||||||||||
| PHYSICIAN | $715,082 | $0 | $696,970 | $0 | $16,486 | $0 | $5,646 | $0 | $24,294 | $0 | $1,458,478 | $0 | $0 | $0 |
| DAVID MIKOLYZK MD | ||||||||||||||
| PHYSICIAN | $705,836 | $0 | $144,631 | $0 | $19,382 | $0 | $5,646 | $0 | $29,175 | $0 | $904,670 | $0 | $10,242 | $0 |
| CHARLES L LAHAM MD | ||||||||||||||
| PHYSICIAN | $524,592 | $0 | $8,000 | $0 | $1,732 | $0 | $5,646 | $0 | $29,709 | $0 | $569,679 | $0 | $0 | $0 |
| NANCY N BUTLER MD | ||||||||||||||
| PHYSICIAN | $330,609 | $0 | $241,437 | $0 | $101,545 | $0 | $5,646 | $0 | $10,794 | $0 | $690,031 | $0 | $0 | $0 |
| JEFFREY A JACOBY MD | ||||||||||||||
| PHYSICIAN | $544,232 | $0 | $647,605 | $0 | $540 | $0 | $5,646 | $0 | $23,052 | $0 | $1,221,075 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | CIVIC PAY, CEO, CFO, KEY EMPLOYEES (5 EMPLOYEES - $1,650-$5,776), BENEFIT TREATED AS TAXABLE INCOME CIVIC DUES, 1 KEY EMPLOYEE ($660), BENEFIT NOT TREATED AS TAXABLE INCOME |
| PART I, LINE 6 | THE SENIOR SUCCESSSHARE PROGRAM IS AN AT RISK COMPENSATION PROGRAM WHICH IS BASED ON BALANCED STRATEGIC ACCOMPLISHMENTS AS APPROVED ANNUALLY BY THE COMPENSATION AND EVALUATION SUBCOMMITTEE OF THE BOARD OF DIRECTORS. ELIGIBLE PERSONS INCLUDE THE PRESIDENT/CEO, CHIEF MEDICAL OFFICER, CHIEF FINANCIAL OFFICER, AND CHIEF INNOVATION OFFICER. |
| PART I, LINE 7 | A PORTION OF PHYSICIAN SALARY IS BASED ON INDIVIDUAL PRODUCTION FOR PERSONALLY RENDERED SERVICES. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| WISCONSIN HEALTH AND EDUCATION FACILITIES | ||||||||
| A | 391337855 | 97710VPE2 | 2003-09-09 | $9,922,000 | SEE SCHEDULE K, PART V | 0 | 0 | 0 |
| WISCONSIN HEALTH AND EDUCATION FACILITIES | ||||||||
| B | 391337855 | 97710V2S6 | 2007-04-26 | $45,170,000 | SEE SCHEDULE K, PART V | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | In Reserve FundInReserveFundAmt |
|---|---|---|---|---|---|---|---|---|---|---|
| A | $1,839,000 | $9,922,000 | $244,000 | $9,677,000 | 2006 | 0 | 0 | Yes (1) | Yes (1) | |
| B | $5,117,000 | $45,170,000 | $485,000 | $4,990,000 | 2009 | Yes (1) | Yes (1) | Yes (1) | Yes (1) | $2,553,000 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | Yes (1) | Yes (1) | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DATE REBATE COMPUTATION PERFORMED | ISSUER NAME: WISCONSIN HEALTH AND EDUCATION FACILITIES DATE THE REBATE COMPUTATION WAS PERFORMED: 10/06/2008 ISSUER NAME: WISCONSIN HEALTH AND EDUCATION FACILITIES DATE THE REBATE COMPUTATION WAS PERFORMED: 06/01/2012 |
| PART I, LINE A, COLUMN F: | THE PURPOSE OF THE BOND ISSUE WAS A PROJECT CONSISTING OF THE CONSTRUCTION, RENOVATION AND EQUIPPING OF AMBULATORY CARE, DIAGNOSTIC IMAGING, REHABILITATION, OCCUPATIONAL MEDICINE, PRIMARY CARE AND ORTHOPEDIC FACILITIES AT CERTAIN HOLY FAMILY MEMORIAL HEALTH FACILITIES. |
| PART I, LINE B, COLUMN F: | THE PURPOSE OF THE BOND ISSUE WERE 1) THE ACQUISITION, CONSTRUCTION, RENOVATION, REMODELING AND EQUIPPING OF CERTAIN HOSPITAL AND OTHER HEALTHCARE FACILITIES AS IDENTIFIED IN A NOTICE OF PUBLIC HEARING PUBLISHED IN CONNECTION WITH THE ISSUANCE OF THE BONDS INCLUDING THE ACQUISITION OF TELEMETRY MONITORS AND AN MRI SYSTEM 2) THE CURRENT REFUNDING OF ALL THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE (WHEFA) BONDS, SERIES 1995, 3) THE ADVANCE REFUNDING OF ALL OF THE WHEFA BONDS, SERIES 1998A, AND 4) THE ADVANCE REFUNDING OF A PORTION OF THE WHEFA BONDS, SERIES 2003A. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| NORTH END HOME MED SVC LLC | |||
| SERVE AS DIRECTORS ON BOTH ORGANIZATIONS | -$64,970 | INCOME FROM CONTINUOUS OPS - 100% OWNED | 0 |
| HOLY FAMILY HEALTH SERVICES | |||
| SERVE AS DIRECTORS ON BOTH ORGANIZATIONS | $379,528 | INCOME FROM CONTINUOUS OPERATIONS - 100% OWNED | 0 |
| LINDSAY BRISCH | |||
| DAUGHTER OF DIRECTOR/OFFICER | $25,578 | REPORTABLE COMPENSATION (W2) AND ESTIMATE OF OTHER COMPENSATION | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | HOLY FAMILY MEMORIAL IS SPONSORED BY FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC. WHICH IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | HOLY FAMILY MEMORIAL OPERATES AN INTEGRATED HEALTHCARE DELIVERY SYSTEM, PRIMARILY TO THE RESIDENTS OF MANITOWOC COUNTY, WISCONSIN. HOLY FAMILY MEMORIAL IS OPERATED BY FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC., WHICH IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC. IS A NOT-FOR-PROFIT HEALTHCARE HOLDING COMPANY INCORPORATED TO MONITOR AND MANAGE HEALTHCARE OPERATIONS. THE BOARD OF DIRECTORS SHALL CONSIST OF NO MORE THAN EIGHTEEN INDIVIDUALS. THE PRESIDENT OF THE CORPORATION AND CHAIR OF THE PHYSICIAN COUNCIL SHALL BE EX-OFFICIO MEMBERS WITH FULL VOTING PRIVILEGES. IN ADDITION TO THE EX-OFFICIO BOARD POSITIONS, THE BOARD OF DIRECTORS SHALL INCLUDE FOUR MEMBERS OF FRANCISCAN SISTERS OF CHRISTIAN CHARITY AND AT LEAST FOUR PHYSICIANS. |
| FORM 990, PART VI, SECTION A, LINE 7B | SOME DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE MEMBER AS OUTLINED IN THE CORPORATE BYLAWS. FOR EXAMPLE, THE GOVERNING BOARD SUBMITS NAMES OF NEW BOARD MEMBERS TO THE MEMBER AND THE MEMBER APPOINTS THEM. APPROVAL OF THE BUDGET, MORTGAGE, PHILOSOPHY, MISSION & VISION, LEASE OR SALE OF REAL ESTATE MUST BE APPROVED BY THE MEMBER. A CERTIFIED AUDIT OF CORPORATE FUNDS OR THE ANNUAL FISCAL AUDIT MUST BE APPROVED BY THE MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE CHAIR OF THE GOVERNING BOARD REVIEWS THE 990 PRIOR TO FILING. AN OVERVIEW OF THE 990 ALONG WITH SPECIFIC SECTIONS ON GOVERNANCE, COMMUNITY BENEFITS, AND CONFLICT OF INTEREST IS PRESENTED TO THE BOARD OR BOARD COMMITTEE. THE COMPENSATION AND EVALUATION SUBCOMMITTEE REVIEWS THE 990 SECTIONS RELATED TO COMPENSATION PRIOR TO FILING. COPIES ARE AVAILABLE TO ALL BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, GOVERNING BOARD MEMBERS ARE PROVIDED A COPY OF THE CONFLICT OF INTEREST POLICY TO REVIEW AND SIGN THE CERTIFICATION ON WHICH THEY DISCLOSE ANY CONFLICTS. AT EACH BOARD OR COMMITTEE MEETING WHERE THERE WILL BE A VOTE, THE CHAIRPERSON ASKS IF THERE ARE ANY CONFLICTS TO THE PARTICULAR ISSUE. IF THERE IS A CONFLICT, THAT PERSON ABSTAINS FROM DISCUSSION & VOTING. ALL PHYSICIANS, LEADERS, AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST ANNUALLY. CONFLICT OF INTEREST IS MONITORED THROUGH HOLY FAMILY MEMORIAL'S COMPLIANCE DEPARTMENT. |
| FORM 990, PART VI, SECTION B, LINE 15 | LINES 15 A & B - HOLY FAMILY MEMORIAL HAS A SENIOR LEADER COMPENSATION POLICY. THE PROCESS OF DETERMINING THESE SALARIES IS GOVERNED BY THE COMPENSATION AND EVALUATION SUBCOMMITTEE OF THE BOARD. THE POLICY COVERS THE FOLLOWING POSITIONS: PRESIDENT AND CEO, CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER AND CHIEF INNOVATION OFFICER. SENIOR LEADER SALARY DATA IS EVALUATED ANNUALLY BY AN EXTERNAL EXECUTIVE COMPENSATION FIRM. TOTAL COMPENSATION FOR SENIOR LEADERS (SALARY, BENEFITS AND INCENTIVE) IS EVALUATED EVERY THREE YEARS BY AN EXTERNAL EXECUTIVE COMPENSATION FIRM (LAST DONE DEC 2011). ALSO CONSIDERED ARE CURRENT MARKET CONDITIONS AND MARKET COMPETITIVENESS. THE POLICY REFLECTS HOLY FAMILY MEMORIAL'S MISSION AND VALUES AND THE LOCAL COMMUNITY EXPERIENCE BY EMPHASIZING REWARDS BASED ON WELL ROUNDED ACCOMPLISHMENTS IN THE AREAS OF MISSION AND RELATIONSHIPS, KEY STRATEGIES AND OPERATIONS, INCLUDING FINANCE. |
| FORM 990, PART VI, SECTION C, LINE 19 | HOLY FAMILY MEMORIAL'S ARTICLES OF INCORPORATION ARE PUBLICLY AVAILABLE FROM THE WI DEPARTMENT OF FINANCIAL INSTITUTIONS. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. HOLY FAMILY MEMORIAL'S FINANCIAL STATEMENTS ARE AVAILABLE ON THE DACBOND.COM WEBSITE AND HOLY FAMILY MEMORIAL SUBMITS FINANCIAL INFORMATION TO THE STATE OF WI ANNUALLY. OUR FORM 990 IS AVAILABLE UPON REQUEST AND CAN BE SEEN ON THE GUIDESTAR WEBSITE. |
| FORM 990, PART VII, SECTION A, PART 1A LINES 1 THROUGH 5: | HOLY FAMILY MEMORIAL'S BOARD OF DIRECTORS INCLUDES SIX EMPLOYED PROVIDERS. THE COMPENSATION REPORTED FOR THESE DIRECTORS IS FOR THEIR SERVICES AS A PROVIDER. |
| FORM 990, PART XI, LINE 9: | RESTRICTED CONTRIBUTIONS NET OF ASSETS RELEASED 181,999. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX PROCESS. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH END HOME MED SCS LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3310 CALUMET AVENUE | AddressLine1 |
| City | MANITOWOC | City |
| State | WI | State |
| ZIP Code | 54220 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391868808 | EIN |
| Primary Activities | MEDICAL EQUIPMENT | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Total Income | -$63,611 | TotalIncomeAmt |
| End Of Year Assets | $1,984,169 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HFM INC | BusinessNameLine1 |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| FRANCISCAN SISTERS OF CHRISTIAN CHARITY | ||||||||||
| 1415 SOUTH RAPIDS ROAD | MANITOWOC | WI | 54220 | 391530622 | HEALTHCARE | WI | 501(C)(3) | LINE 1 | N/A | 0 |
| ST PAUL ELDER SERVICES INC | ||||||||||
| 316 EAST 14TH STREET | KAUKAUNA | WI | 54130 | 391029149 | ELDER CARE | WI | 501(C)(3) | LINE 1 | N/A | 0 |
| GOOD SAMARITAN MEDICAL CENTER | ||||||||||
| 800 FOREST AVENUE | ZANESVILLE | OH | 43701 | 314379479 | HOLDING CO. | OH | 501(C)(3) | LINE 3 | N/A | 0 |
| FRANCISCAN CARE SERVICES INC | ||||||||||
| 430 N MONITOR ST | WEST POINT | NE | 68788 | 470486026 | HEALTHCARE | NE | 501(C)(3) | LINE 3 | N/A | 0 |
| SILVER LAKE COLLEGE OF THE HOLY FAMILY INC | ||||||||||
| 2406 SOUTH ALVERNO ROAD | MANITOWOC | WI | 54220 | 390980974 | HIGHER EDUCATION | WI | 501(C)(3) | LINE 2 | N/A | 0 |
| HOLY FAMILY CONVENT OF THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY | ||||||||||
| 2409 SOUTH ALVERNO ROAD | MANITOWOC | WI | 54220 | 390808523 | RELIGIOUS | WI | 501(C)(3) | LINE 1 | N/A | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLY FAMILY HEALTH SERVICES | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3310 CALUMET AVENUE | AddressLine1 |
| City | MANITOWOC | City |
| State | WI | State |
| ZIP Code | 54220 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391572253 | EIN |
| Primary Activities | PHARMACY | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HFM INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $228,915 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $1,746,900 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| HOLY FAMILY HEALTH SERVICES - REIMBURSEMENT OF SALARYBENEFITSUPPLIESRENT | ||
| Q | $942,554 | ACTUAL REVENUE |
| FRANCISCAN SISTERS OF CHRISTIAN CHARITY - BUILDING RENT | ||
| J | $51,425 | ACTUAL REVENUE |
| FRANCISCAN SISTERS OF CHRISTIAN CHARITY - AUDIT FEES | ||
| P | $83,930 | ACTUAL EXPENSE |
| FRANCISCAN SISTERS OF CHRISTIAN CHARITY - ADMINISTRATIVE SERVICES | ||
| P | $701,000 | ACTUAL EXPENSE |
| FRANCISCAN SISTERS OF CHRISTIAN CHARITY-LIABBUILDINGWORKERS COMP INSURANC | ||
| P | $1,392,264 | ACTUAL EXPENSE |
| FRANCISCAN SISTERS OF CHRISTIAN CHARITY - HEALTH INSURANCE PREMIUMS | ||
| P | $9,499,000 | ACTUAL EXPENSE |
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