LANGLADE HOSPITAL-HOTEL DIEU OF ST JOSEPH OF ANTIGO WISCONSIN: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- LANGLADE HOSPITAL-HOTEL DIEU OF ST JOSEPH OF ANTIGO WISCONSIN (EIN 39-0806429)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-04-15
- IRS object ID
- 201311059349300906
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-04-15T13:18:20-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390758449 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 469 SECURITY BLVD | AddressLine1 |
| City | GREEN BAY | City |
| State | WI | State |
| ZIP Code | 54313 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390806429 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LANGLADE HOSPITAL - HOTEL DIEU OF | BusinessNameLine1 |
| Business Name Line2 | ST JOSEPH OF ANTIGO WISCONSIN | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LANG | NameControl |
| Phone | 7156232331 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 112 E FIFTH AVE | AddressLine1 |
| City | ANTIGO | City |
| State | WI | State |
| ZIP Code | 54409 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PAT TINCHER | Name |
| Title | CFO | Title |
| Phone | 7156232331 | Phone |
| Date Signed | 2013-03-06 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| PTIN | P00096513 | PTIN |
| Phone | 9206620016 | Phone |
| Date Prepared | 2013-03-06 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LANGLADE HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | PAT TINCHER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 112 E FIFTH AVE | AddressLine1 |
| City | ANTIGO | City |
| State | WI | State |
| ZIP Code | 54409 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 81204789 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.LANGLADEHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1933 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | THE COMMUNITY BENEFIT CONTRIBUTION OF LANGLADE HOSPITAL INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTH CARE AND IMPROVE HEALTH IN OUR COMMUNITIES. IN ORDER TO PORTRAY THE FULL BREADTH OF OUR CONTRIBUTION, OUR COMMUNITY BENEFIT INFORMATION IS DESCRIBED BELOW:HISTORYTHE HOSPITAL WAS OPENED ON MARCH 21, 1933 AND WAS DEDICATED AS A MEMORIAL TO THE SERVICEMEN FROM LANGLADE COUNTY WHO SACRIFICED THEIR LIVES DURING WORLD WAR I. IT IS OWNED AND OPERATED BY THE RELIGIOUS HOSPITALLERS OF ST. JOSEPH.THE RELIGIOUS HOSPITALLERS OF ST. JOSEPH ARE A RELIGIOUS ORDER OF CATHOLIC SISTERS WHOSE ROOTS AS A RELIGIOUS CONGREGATION GO BACK TO THE 17TH CENTURY FRANCE. IN 1659, THEIR FOUNDER, JEROME LEROYER, A LAYMAN AND FATHER OF FIVE CHILDREN, CAME TO MONTREAL, CANADA AND ESTABLISHED THE CONGREGATION OF THE RELIGIOUS HOSPITALLERS OF ST. JOSEPH. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 18 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 596 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 448254 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -228042 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 183790 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 750788 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 68597866 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 75516469 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1265437 | InvestmentIncomePriorYear |
| Investment Income Current Year | 509738 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 137272 | OtherRevenuePriorYear |
| Other Revenue Current Year | 6165 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 70184365 | TotalRevenuePriorYear |
| Total Revenue Current Year | 76783160 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 31726499 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 38356668 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 33877198 | OtherExpensePriorYear |
| Other Expenses Current Year | 29157693 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 65603697 | TotalExpensesPriorYear |
| Total Expenses Current Year | 67514361 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4580668 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 9268799 | RevenuesLessExpensesCY |
| Total Assets BOY | 71670421 | TotalAssetsBOY |
| Total Assets EOY | 95522195 | TotalAssetsEOY |
| Total Liabilities BOY | 10553313 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 19679637 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 61117108 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 75842558 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | AS A MINISTRY OF JESUS, WE HEAL, PROMOTE HEALTH, AND ENRICH LIVES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 35939162 | Expense |
| Revenue | 59664449 | Revenue |
| Description | ACUTE GENERAL CARE HOSPITAL WITH BOTH INPATIENT AND OUTPATIENT RELATED SERVICES, AND SUPPORTIVE HOMECARE SERVICES FOR ELDERLY CLIENTS.- INPATIENTS - 897 ADMISSIONS WITH 3,680 PATIENT DAYS AND 201 BIRTHS.- OUTPATIENTS - 58,665 OUTPATIENT VISITS, INCLUDING 11,504 EMERGENCY VISITS, 25,754 IMAGING PROCEDURES.- SURGICAL SERVICES - 1,401 TOTAL PATIENTS TREATED. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 13969769 | Expense |
| Revenue | 13517919 | Revenue |
| Description | PHYSICIAN CLINIC SERVICES - URGENT CARE, PRIMARY CARE, AND VARIOUS SPECIALTIES.- CLINIC VISITS - 68,553 | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1193672 | Expense |
| Revenue | 1023286 | Revenue |
| Description | ELDERLY HOUSING AND SUPPORT SERVICES- INDEPENDENT LIVING - 12,201 RESIDENT DAYS- ASSISTED LIVING - 5,199 RESIDENT DAYS- ADULT DAY CARE - 590 TREATMENT DAYS- HOSPICE - 3,241 PATIENT DAYS | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 892952 | Expense |
| Revenue | 255801 | Revenue |
| Description | PROVIDING DAYCARE, PATHOLOGY SERVICES AND MEALS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 892952 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 255801 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 51995555 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 724 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 596 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 18 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAT TINCHER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7156232331 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 112 EAST FIFTH AVENUE | AddressLine1 |
| City | ANTIGO | City |
| State | WI | State |
| ZIP Code | 54409 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (25 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JOE JOPEK | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| MIKE TURNEY | |||||||
| CHAIRMAN | 1.00 | X | 0 | 0 | 0 | ||
| SISTER DOLORES DEMULLING | |||||||
| SECRETARY/TREASURER | 1.00 | X | 50565 | 0 | 0 | ||
| NOEL DEEP MD | |||||||
| BOARD MEMBER | 1.00 | X | 401589 | 0 | 35919 | ||
| MIKE WINTER | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| LYNNE HENRICKS | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| SISTER JEAN BRICCO | |||||||
| BOARD MEMBER | 1.00 | X | 79269 | 0 | 0 | ||
| JOE SVEDA | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| CHARLES HEUSS MD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DAWN OFSTHUN | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| RICHARD HIGLEY | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| TOM BRADLEY | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JAMES MOERMOND MD | |||||||
| BOARD MEMBER | 1.00 | X | 219324 | 0 | 33891 | ||
| KRISTINE FLOWERS MD | |||||||
| BOARD MEMBER | 1.00 | X | 220735 | 0 | 33652 | ||
| SID SCZYGELSKI | |||||||
| BOARD MEMBER | 1.00 | X | 377724 | 0 | 30704 | ||
| DEAN DANNER | |||||||
| BOARD MEMBER | 1.00 | X | 289118 | 0 | 24645 | ||
| SCOTT GARAVET | |||||||
| BOARD MEMBER | 1.00 | X | 139528 | 0 | 30353 | ||
| SISTER ROSE-MARIE DUFAULT | |||||||
| BOARD MEMBER | 1.00 | X | 79269 | 0 | 0 | ||
| DAVID SCHNEIDER | |||||||
| CEO | 40.00 | 358282 | 0 | 39426 | X | ||
| PATRICK TINCHER | |||||||
| CFO | 40.00 | 185498 | 0 | 40301 | X | ||
| STACY BROWNELL | |||||||
| PHARMACY MANAGER | 40.00 | 131216 | 0 | 17296 | X | ||
| JAMES LEEK MD | |||||||
| PHYSICIAN | 40.00 | 383702 | 0 | 18844 | X | ||
| MARK SZMANDA MD | |||||||
| PHYSICIAN | 40.00 | 257580 | 0 | 29168 | X | ||
| JANELLE A MARKGRAF | |||||||
| HR DIRECTOR | 40.00 | 128985 | 0 | 15816 | X | ||
| RUTH RISLEY-GRAY | |||||||
| DIRECTOR - PATIENT SERVICE | 40.00 | 147067 | 0 | 36660 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3449451 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 386675 | TotalOtherCompensation |
| Number Individuals GT100 K | 13 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MIRON CONSTRUCTION INC | |||||
| 1471 MCMAHON RD | NEENAH | WI | 54956 | CONSTRUCTION | 13722603 |
| ASPIRUS CLINICS INC | |||||
| 3000 WESTHILL DR | WAUSAU | WI | 54401 | CLINICAL | 10242802 |
| ADVANTAGE PURCHASING LLC | |||||
| 1471 MCMAHON RD | NEENAH | WI | 54956 | CONSTRUCTION MANAGEMENT | 6542859 |
| GE HEALTHCARE | |||||
| 3000 N GRANDVIEW BLVD | WAUKESHA | WI | 53188 | MEDICAL EQUIPMENT | 3376239 |
| MCKESSON DRUG CO | |||||
| 1 POST STREET | SAN FRANCISCO | CA | 94104 | PHARMACEUTICAL | 2659526 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 46 | NumberOfContractorsGT100K |
| Related Organizations | 200000 | RelatedOrganizations |
| Government Grants | 512219 | GovernmentGrants |
| All Other Contributions | 38569 | AllOtherContributions |
| Total Contributions | 750788 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| ACUTE HOSPITAL SERVICE | 621990 | 59664449 | 59664449 | |
| PHYSICIAN CLINICS | 621110 | 13517919 | 13517919 | |
| MISCELLANEOUS | 621990 | 606760 | $606,760 | |
| ROSALIA GARDENS | 623990 | 514213 | 514213 | |
| CONGREGATE HOUSING | 623990 | 509073 | 509073 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 704055 | TotalRevenueColumn |
| Related Or Exempt Function Income | 255801 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 448254 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 75516469 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 282569 | TotalRevenueColumn |
| Exclusion | $282,569 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 97885 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 91720 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 6165 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6165 | TotalRevenueColumn |
| Exclusion | $6,165 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4557078 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4328786 | Securities |
| Other | 1123 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 228292 | Securities |
| Other | -1123 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 227169 | TotalRevenueColumn |
| Exclusion | $227,169 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 76783160 | TotalRevenueColumn |
| Related Or Exempt Function Income | 74461455 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 448254 | UnrelatedBusinessRevenue |
| Exclusion | $1,122,663 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29451808 | Total |
| Program Services | 24597195 | ProgramServices |
| Management And General | 4854613 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1263785 | Total |
| Program Services | 1055472 | ProgramServices |
| Management And General | 208313 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5724255 | Total |
| Program Services | 4780712 | ProgramServices |
| Management And General | 943543 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1916820 | Total |
| Program Services | 1600866 | ProgramServices |
| Management And General | 315954 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 105291 | Total |
| Program Services | 500 | ProgramServices |
| Management And General | 104791 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54328 | Total |
| Management And General | 54328 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17281 | Total |
| Program Services | 13495 | ProgramServices |
| Management And General | 3786 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10583252 | Total |
| Program Services | 8277335 | ProgramServices |
| Management And General | 2305917 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 182321 | Total |
| Program Services | 1224 | ProgramServices |
| Management And General | 181097 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 655106 | Total |
| Program Services | 98916 | ProgramServices |
| Management And General | 556190 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1062099 | Total |
| Program Services | 757529 | ProgramServices |
| Management And General | 304570 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 260712 | Total |
| Program Services | 163040 | ProgramServices |
| Management And General | 97672 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50199 | Total |
| Management And General | 50199 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5158395 | Total |
| Program Services | 2047362 | ProgramServices |
| Management And General | 3111033 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 407114 | Total |
| Program Services | 135891 | ProgramServices |
| Management And General | 271223 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL/PROFESSIONAL | 6584353 | 6491877 | 92476 |
| BAD DEBT EXPENSE | 1641044 | 96992 | 1544052 |
| MAINTENANCE AND REPAIR | 1512852 | 1419094 | 93758 |
| MINOR EQUIPMENT | 589960 | 354941 | 235019 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 293386 | Total |
| Program Services | 103114 | ProgramServices |
| Management And General | 190272 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67514361 | Total |
| Program Services | 51995555 | ProgramServices |
| Management And General | 15518806 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8295097 | BOY |
| EOY | 15073076 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11199962 | BOY |
| EOY | 2418791 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7958694 | BOY |
| EOY | 10070033 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1071840 | BOY |
| EOY | 1193211 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 670415 | BOY |
| EOY | 125383 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 75733088 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 20464136 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31888102 | BOY |
| EOY | 55268952 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6840013 | BOY |
| EOY | 6994635 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2296742 | BOY |
| EOY | 843572 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1449556 | BOY |
| EOY | 3534542 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71670421 | BOY |
| EOY | 95522195 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9065228 | BOY |
| EOY | 10013301 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 9666336 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1488085 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10553313 | BOY |
| EOY | 19679637 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60169756 | BOY |
| EOY | 75102913 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 947352 | BOY |
| EOY | 739645 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61117108 | BOY |
| EOY | 75842558 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71670421 | BOY |
| EOY | 95522195 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 9268799 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 5456651 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 852646 | OtherCostOrOtherBasis |
| Book Value | 852646 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 48050522 | OtherCostOrOtherBasis |
| Depreciation | 4630045 | Depreciation |
| Book Value | 43420477 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1788660 | OtherCostOrOtherBasis |
| Depreciation | 949797 | Depreciation |
| Book Value | 838863 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 24371094 | OtherCostOrOtherBasis |
| Depreciation | 14884294 | Depreciation |
| Book Value | 9486800 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 670166 | OtherCostOrOtherBasis |
| Book Value | 670166 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 55268952 | TotalOfBookValueLandBuildings |
| Total Revenue | 76783160 | TotalRevenue |
| Total Expenses | 67514361 | TotalExpenses |
| Excess Or Deficit For Year | 9268799 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -320270 | NetUnrealizedGLOnInvestments |
| Other | $5,776,921 | OtherAmount |
| Total Adjustments | 5456651 | TotalAdjustments |
| Excess Or Deficit Per FS | 14725450 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 76354610 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -320270 | NetUnrealizedGainsInvestments |
| Other Revenues | 91720 | OtherRevenues |
| Revenue Not Rptd F990 | -228550 | RevenueNotRptdF990 |
| Revenue Subtotal | 76583160 | RevenueSubtotal |
| Other Revenues Not Included | 200000 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 200000 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 76783160 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 67606081 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 91720 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 91720 | ExpensesNotRptdF990 |
| Expenses Subtotal | 67514361 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 67514361 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ORGANIZATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION'S POLICY IS TO RECOGNIZE INTEREST AND ANY PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE WHEN INCURRED. AS OF AND FOR THE YEARS ENDED JUNE 30, 2012 AND 2011, THERE WAS NO INCOME TAX EXPENSE, TAX PENALTIES, OR INTEREST RELATED TO TAX PENALTIES RECORDED BY THE ORGANIZATION IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS IN 2012 OR 2011. FEDERAL RETURNS FOR THE SIX-MONTH PERIOD ENDED JUNE, 2009, AND THE YEARS ENDED JUNE 30, 2010 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | CHANGE IN INTEREST IN FOUNDATION -207,707. MEMBER CONTRIBUTION 4,539,628. TRANSFER FROM AFFILIATED ORGANIZATION 1,000,000. FORGIVENESS OF NOTE BY AFFILIATED ORGANIZATION 445,000. TOTAL TO SCHEDULE D, PART XI, LINE 8: 5,776,921. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 91,720. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | FOUNDATION CONTRIBUTION 200,000. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 91,720. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 912807 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 912807 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01390 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9985132 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8236998 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1748134 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02650 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10897939 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8236998 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2660941 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04040 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1606858 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1126542 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 480316 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00730 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 28858 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 28858 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9013911 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9013911 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13680 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 76093 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 76093 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10725720 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1126542 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9599178 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.14570 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 21623659 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9363540 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12260119 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.18610 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $813,909 | BadDebtExpenseAmount |
| Amount Attributable To | 406955 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 18209387 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 18802714 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -593327 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 0 | WrittenDebtCollectionPolicy |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LANGLADE HOSPITAL - AN ASPIRUS PARTNER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 112 E 5TH AVENUE | AddressLine1 |
| City | ANTIGO | City |
| State | WI | State |
| ZIP Code | 54409 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LANGLADE HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 150.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 0 | ExplainsBasis |
| Explains Application Method | 0 | ExplainsApplicationMethod |
| Includes Publicity Measures | 0 | IncludesPublicityMeasures |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 5 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (5 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| ASPIRUS GENERAL CLINIC | ||||
| 110 E 5TH AVE | ANTIGO | WI | 54409 | CLINIC PROVDING A WIDE RANGE OF OUTPATIENT SERVICES |
| ASPIRUS GENERAL CLINIC | ||||
| 400 RAILROAD | BIRNAMWOOD | WI | 54414 | CLINIC PROVDING A WIDE RANGE OF OUTPATIENT SERVICES |
| ASPIRUS GENERAL CLINIC | ||||
| W10618 CLINIC ST | ELCHO | WI | 54428 | CLINIC PROVDING A WIDE RANGE OF OUTPATIENT SERVICES |
| PINE MEADOWS RETIREMENT COMMUNITY | ||||
| 525 FLIGHT RD | ANTIGO | WI | 54409 | SENIOR HOUSING |
| ROSALIA GARDENS ASSITED LIVING | ||||
| 525 FLIGHT RD | ANTIGO | WI | 54409 | ASSISTED LIVING |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: THE COST-TO-CHARGE RATIO FROM THE MEDICARE COST REPORT IS USED PURSUANT TO IRS WORKSHEET 2. | ||
| PART I, LINE 7G: PHYSICIAN CLINICS ARE INCLUDED IN THE AMOUNT OF SUBSIDIZED HEALTH SERVICES. | ||
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1641043. | ||
| PART II: THE HOSPITAL'S COMMUNITY BUILDING ACTIVITIES FOCUS ON EFFORTS TO ENRICH THE LIVES OF COMMUNITY MEMBERS WHO ARE STRUGGLING WITH ISSUES THAT MAY HAVE A NEGATIVE IMPACT ON THEIR HEALTH. | ||
| PART III, LINE 4: COST IS CALCULATED USING THE COST TO CHARGE RATIO METHODOLOGY. | ||
| PART III, LINE 8: ANY SHORTFALL IS TREATED AS A COMMUNITY BENEFIT SINCE THE HOSPITAL IS PROVIDING SERVICES AT A LOSS WHICH ARE ESSENTIAL TO THE COMMUNITY. THE AMOUNTS OF MEDICARE ALLOWANCE COSTS ARE DETERMINED USING THE PRINCIPLES OF MEDICARE REIMBURSEMENT. | ||
| PART V, SECTION B, LINE 19D: USUAL CHARGES ARE BILLED LESS A PRE-ESTABLISHED DISCOUNT PERCENTAGE | LANGLADE HOSPITAL | |
| PART VI, LINE 2: MANAGEMENT REVIEWS HEALTH AND SOCIAL DATA AND TRENDS TO DETERMINE WHETHER THERE IS AN UNMET NEED WITHIN THE COMMUNITY. | ||
| PART VI, LINE 3: THE HOSPITAL UTILIZES PATIENT FINANCIAL SERVICES COUNSELORS WHO WORK WITH PATIENTS ON A ONE ON ONE BASIS TO EDUCATE THE PATIENT/MAKE THEM AWARE OF THE AVAILABLE OPTIONS. THE HOSPITAL ALSO PARTNERS WITH A LOCAL CREDIT UNION TO PROVIDE INFORMATION REGARDING RESOURCES AVAILABLE TO THE RESIDENTS OF THE MARKETS SERVED. | ||
| PART VI, LINE 4: LANGLADE HOSPITAL SERVES THE POPULATION OF LANGLADE COUNTY AND SURROUNDING COUNTIES. LANGLADE COUNTY IS A RURAL COUNTY WITH NO TOWNS OF ANY SIGNIFICANT SIZE. THE POPULATION IS AGING AND PROJECTIONS INDICATE 50% OF THE POPULATION WILL BE OVER 64 YEARS OF AGE BY 2018. VERY LITTLE GROWTH IS PROJECTED FOR THE SERVICE AREA IN THE COMING YEARS. LANGLADE COUNTY HAS TRADITIONALLY SEEN HIGH RATES OF UNEMPLOYMENT. THERE ARE NO OTHER HOSPITALS IN THE IMMEDIATE AREA THAT SERVE LANGLADE COUNTY. THERE ARE HOSPITALS IN RHINELANDER AND IN WAUSAU; HOWEVER, DEPENDING UPON LOCATION IN LANGLADE COUNTY, THESE FACILITIES WOULD BE FAIRLY FAR AWAY. | ||
| PART VI, LINE 5: THE BOARD OF DIRECTORS IS COMPRISED OF 18 INDIVIDUALS FROM THE SURROUNDING AREA. OF THESE 18 BOARD MEMBERS, 12 ARE INDEPENDENT. THE HOSPITAL DOES EXTEND PRIVILEGES TO ALL QUALIFIED LOCAL PHYSICIANS. THE HOSPITAL PARTICIPATES IN LOCAL HEALTH FAIRS AND PROVIDES FREE SCREENINGS THROUGH THESE HEALTH FAIRS. | ||
| PART VI, LINE 6: EACH ORGANIZATION DETERMINES THE NEEDS OF THEIR RESPECTIVE COMMUNITIES. WHERE APPROPRIATE, ORGANIZATIONS SHARE RESOURCES SUCH AS PHYSICIANS FOR PRESENTATIONS, ETC. | ||
| WI | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NOEL DEEP MD | |||||||||||||
| 352635 | 0 | 48954 | 0 | 0 | 0 | 7666 | 0 | 28253 | 0 | 437508 | 0 | 0 | 0 |
| JAMES MOERMOND MD | |||||||||||||
| 205777 | 0 | 2487 | 0 | 11060 | 0 | 6857 | 0 | 27034 | 0 | 253215 | 0 | 0 | 0 |
| KRISTINE FLOWERS MD | |||||||||||||
| 200634 | 0 | 20101 | 0 | 0 | 0 | 6893 | 0 | 26759 | 0 | 254387 | 0 | 0 | 0 |
| SID SCZYGELSKI | |||||||||||||
| 293117 | 0 | 79742 | 0 | 4865 | 0 | 8528 | 0 | 22176 | 0 | 408428 | 0 | 0 | 0 |
| DEAN DANNER | |||||||||||||
| 227939 | 0 | 57789 | 0 | 3390 | 0 | 0 | 0 | 24645 | 0 | 313763 | 0 | 0 | 0 |
| SCOTT GARAVET | |||||||||||||
| 127694 | 0 | 11834 | 0 | 0 | 0 | 5307 | 0 | 25046 | 0 | 169881 | 0 | 0 | 0 |
| DAVID SCHNEIDER | |||||||||||||
| 287228 | 0 | 67095 | 0 | 3959 | 0 | 12438 | 0 | 26988 | 0 | 397708 | 0 | 0 | 0 |
| PATRICK TINCHER | |||||||||||||
| 184803 | 0 | 99 | 0 | 596 | 0 | 9667 | 0 | 30634 | 0 | 225799 | 0 | 0 | 0 |
| JAMES LEEK MD | |||||||||||||
| 380975 | 0 | 101 | 0 | 2626 | 0 | 12250 | 0 | 6594 | 0 | 402546 | 0 | 0 | 0 |
| MARK SZMANDA MD | |||||||||||||
| 256166 | 0 | 103 | 0 | 1311 | 0 | 12250 | 0 | 16918 | 0 | 286748 | 0 | 0 | 0 |
| RUTH RISLEY-GRAY | |||||||||||||
| 145655 | 0 | 104 | 0 | 1308 | 0 | 7683 | 0 | 28977 | 0 | 183727 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE HOSPITAL IS A NONSTOCK NONPROFIT CORPORATION. THE HOSPITAL OPERATES UNDER THE CONTROL AND DIRECTION OF THE RELIGIOUS HOSPITALLERS OF ST. JOSEPH (RHSJ), A RELIGIOUS CONGREGATION OF THE ROMAN CATHOLIC CHURCH AND ASPIRUS, INC. EACH OF WHICH APPOINT 3 BOARD MEMBERS AND JOINTLY APPROVE THE REMAINING MEMBERS. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE HOSPITAL OPERATES UNDER THE CONTROL AND DIRECTION OF THE RELIGIOUS HOSPITALLERS OF ST. JOSEPH (RHSJ), A RELIGIOUS CONGREGATION OF THE ROMAN CATHOLIC CHURCH AND ASPIRUS, INC. EACH OF WHICH APPOINT 3 BOARD MEMBERS AND JOINTLY APPROVE THE REMAINING MEMBERS. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE HOSPITAL OPERATES UNDER THE CONTROL AND DIRECTION OF THE RELIGIOUS HOSPITALLERS OF ST. JOSEPH (RHSJ), A RELIGIOUS CONGREGATION OF THE ROMAN CATHOLIC CHURCH AND ASPIRUS, INC. EACH OF WHICH APPOINT 3 BOARD MEMBERS AND JOINTLY APPROVE THE REMAINING MEMBERS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | REVIEWED BY THE BOARD CHAIR AND VICE-CHAIR AND MADE AVAILABLE TO ALL BOD MEMBERS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUAL COMPLETION OF CONFLICT OF INTEREST STATEMENTS AND BOARD MEMBERS ABSTAINING ON VOTES THAT PRESENT A CONFLICT OF INTEREST. | |
| FORM 990, PART VI, SECTION B, LINE 15 | AN INDEPENDENT HUMAN RESOURCES/COMPENSATION CONSULTING FIRM IS UTILIZED TO CONDUCT A BENEFIT AND COMPENSATION ANALYSIS. THE BOARD OF TRUSTEE'S EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE MEMBERS RELY UPON THIS INDEPENDENT COMPARABILITY DATA TO SUPPORT ANY WAGE ADJUSTMENTS AWARDED SENIOR LEADERSHIP. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES, WHO ARE INDEPENDENT OF HOSPITAL MANAGEMENT, HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS, ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH LANGLADE HOSPITAL. EXECUTIVE PERFORMANCE & COMPENSATION COMMITTEE MANDATE 1. DETERMINE THE COMPENSATION LEVEL FOR ALL EXECUTIVES AND OTHER DISQUALIFIED PERSONS BASED ON THESE REVIEWS A. REVIEW AND APPROVE EXECUTIVE COMPENSATION CHANGES AND TRANSACTIONS IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS B. REVIEW AND APPROVE COMPENSATION CHANGES (INCENTIVE COMPENSATION PLANS; EXECUTIVE BASE SALARIES AND RANGES; EXECUTIVE WELFARE AND RETIREMENT BENEFIT PLANS), AND OTHER EXECUTIVE FRINGE BENEFITS 2. ENGAGE INDEPENDENT, OUTSIDE ADVISORS (E.G., ATTORNEYS, COMPENSATION CONSULTANTS, ETC.) TO PROVIDE OBJECTIVE AND IMPARTIAL COMPENSATION DATA AND EXPRESS AN OPINION ON THE REASONABLENESS OF TOTAL COMPENSATION A. REVIEW PERIODICALLY THE COMPONENTS OF THE EXECUTIVES' TOTAL COMPENSATION PROGRAM TO DETERMINE WHETHER THEY ARE PROPERLY COORDINATED 3. DISCLOSURE AND REPORTING A. REPORT REGULARLY TO THE FULL BOARD ON EXECUTIVE COMPENSATION B. VERIFY THAT COMPENSATION INFORMATION IS APPROPRIATELY AND FULLY DISCLOSED | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION BELIEVES THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE A PART OF THE ORGANIZATION AND ARE NOT AVAILABLE TO THE PUBLIC. | |
| FORM 990, PART VI, LINE 1B | BOTH SISTER DOLORES DEMULLING AND SISTER JEAN BRICCO HAVE A VOW OF POVERTY. ALL OF THE COMPENSATION PAID TO THEM GOES DIRECTLY TO THEIR ORDER, THE RELIGIOUS HOSPITALLERS OF ST. JOSEPH HEALTH. | COMPENSATION AND VOW OF POVERTY |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -320,270. CHANGE IN INTEREST IN FOUNDATION -207,707. MEMBER CONTRIBUTION 4,539,628. TRANSFER FROM AFFILIATED ORGANIZATION 1,000,000. FORGIVENESS OF NOTE BY AFFILIATED ORGANIZATION 445,000. TOTAL TO FORM 990, PART XI, LINE 5: 5,456,651. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C | THE PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. | AUDIT PROCESS |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| RELIGIOUS HOSPITALLERS OF ST JOSEPH HEALTH CORP | |||||||||||
| C/O VAN BRIESEN ROPER 411 E WIS AVE | MILWAUKEE | WI | 53202 | 271341591 | HEALTH CARE | WI | 501(C)(3) | 1 | N/A | 0 | |
| COMMUNITY AND HEALTH FOUNDATION INC | |||||||||||
| 112 E 5TH AVENUE | ANTIGO | WI | 54409 | 391304761 | HEALTH CARE | WI | 501(C)(3) | 7 | 1 | LANGLADE HOSPITAL | |
| ASPIRUS GENERAL CLINIC | |||||||||||
| 110 E 5TH AVENUE | ANTIGO | WI | 54409 | 383741338 | HEALTH CARE | WI | 501(C)(3) | 7 | 1 | LANGLADE HOSPITAL | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 1 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| COMMUNITY HEALTH FOUNDATION | ||
| B | 500000 | FAIR MARKET VALUE |
| ASPIRUS CLINICS INC | ||
| C | 2457020 | FAIR MARKET VALUE |
| COMMUNITY HEALTH FOUNDATION | ||
| C | 200000 | FAIR MARKET VALUE |
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