ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC (EIN 39-0868982)
- Tax period
- 2011-09-01 to 2012-08-31
- Filed
- 2013-04-12
- IRS object ID
- 201331039349300828
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-04-12T18:54:01-05:00 | Timestamp |
| Tax Period End Date | 2012-08-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390758449 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8010 | AddressLine1 |
| City | WAUSAU | City |
| State | WI | State |
| ZIP Code | 544028010 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-09-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390868982 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Riverview Hospital Association | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | RIVE | NameControl |
| Phone | 7154217462 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 410 Dewey Street | AddressLine1 |
| City | Wisconsin Rapids | City |
| State | WI | State |
| ZIP Code | 54494 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHAEL BOVEE | Name |
| Title | Vice President - Finance | Title |
| Phone | 7154217462 | Phone |
| Date Signed | 2013-04-03 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kathleen J LaBrake CPA | Name |
| PTIN | P00164006 | PTIN |
| Phone | 7158453111 | Phone |
| Date Prepared | 2013-04-03 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Michael Bovee | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 410 Dewey Street | AddressLine1 |
| City | Wisconsin Rapids | City |
| State | WI | State |
| ZIP Code | 54494 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 130538648 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.rhahealthcare.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1912 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | To provide compassionate, affordable, state-of-the-art healthcare to our communities. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 712 | TotalNbrEmployees |
| Total Nbr Volunteers | 512 | TotalNbrVolunteers |
| Total Gross UBI | 1206760 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -906281 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 259801 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 322648 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 85270022 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 90608869 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3248255 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2533784 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 25856 | OtherRevenuePriorYear |
| Other Revenue Current Year | 122685 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 88803934 | TotalRevenuePriorYear |
| Total Revenue Current Year | 93587986 | 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 | 40153677 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 41923325 | 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 | 40417664 | OtherExpensePriorYear |
| Other Expenses Current Year | 43900421 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 80571341 | TotalExpensesPriorYear |
| Total Expenses Current Year | 85823746 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 8232593 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 7764240 | RevenuesLessExpensesCY |
| Total Assets BOY | 186452276 | TotalAssetsBOY |
| Total Assets EOY | 197234446 | TotalAssetsEOY |
| Total Liabilities BOY | 57524453 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 56172562 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 128927823 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 141061884 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | To provide compassionate, affordable, state-of-the-art healthcare to our communities. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 64973147 | Expense |
| Revenue | 89106778 | Revenue |
| Description | Riverview Hospital Association owns and operates the following entities: (1) Riverview Hospital, established in 1912; (2) the outpatient Riverview Rehabilitation Center; (3) Riverview Family Clinic - this service includes clinics in Wisconsin Rapids, Nekoosa, and the Rome-Lakes area; (4) the UW Cancer Center Riverview. UWCC-R opened in 2003 in cooperation with UW Comprehensive Cancer Center, Madison; and (5) Riverview Community Dental Clinic. RHA established this clinic in 2009 to serve residents of South Wood County. Riverview Hospital Association provides community benefits programs and services that address identified community health needs regardless of source or availability of payment, and it provides measurable improvement in health access, health status, and the use of health care resources. In addition, the programs and services considered community benefits should meet one or more of the following criteria: *Supports the organization's community-based mission *Targets the problems of the poor or medically underserved *Impacts the health status of the identified community *Reduces community health costs *Is accessible to the entire target community regardless of their ability to pay *Stimulates external community partnershipsFONEMED is a free, confidential telephone service the community can call after the clinics are closed to get routine health advice or general health information from a Registered Nurse. Approximately 1,437 persons benefited from this program.Coalition Building: The Heatlhy People Wood County Obesity Prevention Team is focusing efforts on building environments and policies which can support healthy behavior change in terms of diet and exercise. Riverview's Health Promotion Coordinator also represents Riverview on the Safe Kids Coalition, working to prevent injury and death in children aged 0-14. The Health Promotion Coordinator represents Riverview on the 3-0 Day Committee (Our Bodies, Our Responsibilities). The Committee organizes a teen conference annually focusing on reducing at-risk behavior in junior and senior high students. Approximately 340 persons benefited from these coalitions.Riverview Dental Clinic in Wisconsin Rapids is open to patients who have Medicaid or Badger Care insurance coverage. This insurance is not typically accepted by independent dental clinics. Approximately 4,301 persons benefited from this program in 2012. Riverview Family Clinic physicians are helping educate area junior high students about sexual responsibility. Two physicians took part in several Wisconsin Rapids East Junior High School health classes, sharing information on the topics of sexually transmitted diseases, pregnancy, and pregnancy prevention. Prior to their visits each semester, the physicians share their presentation with the students' parents during a parent meeting and respond to any questions or concerns that may arise. The physicians' visits have been very well received and greatly appreciated by the students, parents, health class instructor and school administration. Approximately 200-250 students attended this program.The Lifeline program is a 24 hour a day personal response system. A Lifeline unit is installed in the "subscriber's" home and operates through their phone line. He/She wears a "personal help button", which they use to alert Lifeline simply by pressing the button. There is also an Auto Alert personal help button, which alerts Lifeline automatically if the subscriber falls. A Lifeline "Monitor" answers the call through the Lifeline unit and they call the subscriber's. After they determine what kind of help is needed, they call the subscriber's "responders", which are friends, neighbors, or relatives that can check on the subscriber, or if the subscriber needs more professional help the Monitor will call for it immediately. The Lifeline program helps people that would otherwise by unable to remain in their homes. It provides them with freedom and security to do so, while also putting their family at ease. Our program helps many people in Wisconsin Rapids and the surrounding area. This past year approximately 300 people benefited from the Lifeline program that Riverview Medical Center offers.Vulnerable people of all ages including the elderly can remain in their home and be self-sufficient by receiving a home delivered meal that meets their specific nutrition requirements. Health conditions or physical disabilities restrict the ability of individuals to remain independent. The Home Delivered Meals Program provides nutrition that is medically therapeutic to address the special needs of clients diagnosed with diabetes, cardiac and pulmonary issues, retinal disease, gluten intolerance, weight loss due to cancer and chewing and swallowing problems. The program also meets the needs of caretakers of the mentally and physically handicapped or Alzheimer's or other dementia disorders by providing meals to allow them to care for their loved ones. Nutrition education is also offered. Community volunteers deliver hot lunches Monday - Friday as well as brown bag meals for weekends. Food is prepared with consideration for each client's personal preferences as well as dietary restrictions. In 2012, 19,130 meals were delivered. 9,347 of the meals delivered were modified to meet specific dietary needs.In an effort to meet the community needs of students in the Wisconsin Rapids area, Riverview Hospital Association offers the opportunity for interested students to experience a glimpse of the role of its professional staff. This service is made available to students who are interested in learning more about health careers. In 2012, Riverview had 85 job shadow participants.Riverview offered a free seminar entitled Understand Your Joint Pain. This seminar discussed what you can do about knee, hip, and other joint pain. Attendants also learned about arthritis, the causes and symptoms, and treatment options including medications, nutrition, exercise, alternative treatments, and new concepts in joint replacement. In 2012, Riverview presented this seminar to 73 individuals. Riverview's Infection Control Nurse presented to some area schools about the importance of good infection prevention and why it is so important. Discussed at these meetings were proper hand washing techniques, other infection prevention basics (nail biting, bathroom etiquette), education about multi-drug resistant organisms, and infectious diseases in our area. Videos were shown portraying real-life cases of surgical site infection. Approximately 85 students benefited from the presentation in 2012.Pooh Visits Riverview is a program sponsored by Riverview Hospital Auxiliary that gives hospital tours to kindergarten children of the Wisconsin Rapids area (including special needs children and home-schooled children). The tours are 1.5 hours long and include a video showing someone calling 9-1-1, an ambulance, the pediatric area of the Emergency Room, the operating room, a patient room in the hospital, the nursery, a hand-washing station, show x-rays of various body parts and provide a gift bag at the end of the tour. The program is offered in the spring and serves 600 young children. | Description |
| Total Program Service Expense | 64973147 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | 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 | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 75 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 1 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 712 | 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 | 15 | 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 | MICHAEL BOVEE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7154217462 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 410 DEWEY ST | AddressLine1 |
| City | WI RAPIDS | City |
| State | WI | State |
| ZIP Code | 54494 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (24 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| DOUGLAS WENZLAFF | ||||||||
| BOARD CHAIR - NOV 2013 | 2.00 | X | X | 0 | 0 | 0 | ||
| JOHN CLARK PHD | ||||||||
| BOARD VICE CHAIR - NOV 2013 | 2.00 | X | X | 0 | 0 | 0 | ||
| DAWN NEUMAN | ||||||||
| TREASURER - OCT 2012 | 2.00 | X | X | 0 | 0 | 0 | ||
| GREGORY NETTESHEIM | ||||||||
| SECRETARY - OCT 2012 | 2.00 | X | X | 0 | 0 | 0 | ||
| MERCEDES DE LAS ALAS MD | ||||||||
| BOARD MEMBER - OCT 2012 | 41.00 | X | 266123 | 0 | 45482 | |||
| ROBERT BENKOWSKI | ||||||||
| BOARD MEMBER - OCT 2012 | 1.00 | X | 0 | 0 | 0 | |||
| COLLEEN DICKMANN | ||||||||
| BOARD MEMBER - NOV 2013 | 1.00 | X | 0 | 0 | 0 | |||
| ROY BRANDELL MD | ||||||||
| BOARD MEMBER - DEC 2014 | 1.00 | X | 0 | 0 | 0 | |||
| KALIN LAMP | ||||||||
| BOARD MEMBER - NOV 2013 | 1.00 | X | 0 | 0 | 0 | |||
| TIMOTHY MANCL | ||||||||
| BOARD MEMBER - NOV 2013 | 1.00 | X | 0 | 0 | 0 | |||
| MARJORIE MILLER MD | ||||||||
| BOARD MEMBER - DEC 2014 | 1.00 | X | 0 | 0 | 0 | |||
| LAWRENCE LEIBERT MD | ||||||||
| BOARD MEMBER - SEPT 2012 | 1.00 | X | 0 | 0 | 0 | |||
| JASON DEITZ | ||||||||
| BOARD MEMBER - DEC 2012 | 1.00 | X | 0 | 0 | 0 | |||
| JAY GRODE | ||||||||
| BOARD MEMBER - DEC 2014 | 1.00 | X | 0 | 0 | 0 | |||
| SUSAN KUNFERMAN | ||||||||
| BOARD MEMBER - DEC 2014 | 1.00 | X | 0 | 0 | 0 | |||
| CELSE BERARD | ||||||||
| PRESIDENT | 40.00 | X | 293485 | 0 | 50458 | |||
| PEGGY OSE | ||||||||
| V.P. - PATIENT SVCS | 40.00 | 161586 | 0 | 33899 | X | |||
| MICHAEL BOVEE | ||||||||
| V.P. - FINANCE | 40.00 | 194050 | 0 | 33465 | X | |||
| RICHARD BAILEY MD FACP | ||||||||
| PRESIDENT OF MEDICAL AFFAIRS | 40.00 | 268515 | 0 | 33814 | X | |||
| RONNIE KIRSCHLING MD | ||||||||
| PHYSICIAN | 40.00 | 1060090 | 0 | 47836 | X | |||
| CRAIG FLINDERS DO | ||||||||
| PHYSICIAN | 40.00 | 312120 | 0 | 46622 | X | |||
| THOMAS FERK DO | ||||||||
| PHYSICIAN | 40.00 | 353253 | 0 | 51020 | X | |||
| JENNIFER MCELROY DO | ||||||||
| PHYSICIAN | 40.00 | 280526 | 0 | 32122 | X | |||
| CHESTON PRICE MD | ||||||||
| PHYSICIAN | 40.00 | 263549 | 0 | 43912 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3453297 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 418630 | TotalOtherCompensation |
| Number Individuals GT100 K | 24 | 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 |
|---|---|---|---|---|---|
| ELLIS STONE CONSTRUCTION CO | |||||
| PO BOX 366 | STEVENS POINT | WI | 54481 | BUILDING CONSTRUCTION SERVICES | 1849425 |
| HMP OF WISCONSIN RAPIDS LTD | |||||
| PO BOX 645037 | CINCINATI | OH | 45264 | HOSPITALISTS - MTHLY SUBSIDY & MGMT FEE | 888812 |
| PARK & ASSOCIATES | |||||
| 3610 DEER ROAD | WISCONSIN RAPIDS | WI | 54494 | LABORATORY SERVICES | 592863 |
| INFINITY HEALTHCARE SC | |||||
| 111 E WISCONSIN AVENUE SUTIE 2100 | MILWAUKEE | WI | 53202 | Emergency Room Physicians & Medical Dire | 570788 |
| NATIONAL WOUND CARE & HYPERBARIC | |||||
| 3087 MOMENTUM PLACE | CHICAGO | IL | 60689 | WOUND CARE & HYPERBARIC FEE | 466494 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 18 | NumberOfContractorsGT100K |
| Fundraising Events | 44878 | FundraisingEvents |
| Related Organizations | 153269 | RelatedOrganizations |
| All Other Contributions | 124501 | AllOtherContributions |
| Total Contributions | 322648 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| PATIENT SERVICES | 900099 | 88305167 | 88305167 | ||
| LAB SERVICE FOR NON PA | 621500 | 915665 | 915665 | ||
| HEALTH RELATED PROGRAM | 900099 | 609834 | 609834 | ||
| FOOD | 900099 | 207653 | $207,653 | ||
| INCOME RECEIVED FROM R | 900099 | 149976 | 149976 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 420574 | TotalRevenueColumn |
| Related Or Exempt Function Income | 41801 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 291095 | UnrelatedBusinessRevenue |
| Exclusion | $87,678 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 90608869 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2288439 | TotalRevenueColumn |
| Exclusion | $2,288,439 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 677119 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 557220 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 119899 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 119899 | TotalRevenueColumn |
| Exclusion | $119,899 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 36553377 | Securities |
| Other | 78698 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 36343269 | Securities |
| Other | 43461 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 210108 | Securities |
| Other | 35237 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 245345 | TotalRevenueColumn |
| Exclusion | $245,345 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 4427 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 44878 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 4427 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 5071 | GrossIncomeGaming |
| Gaming Direct Expenses | 2285 | GamingDirectExpenses |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2786 | TotalRevenueColumn |
| Exclusion | $2,786 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 93587986 | TotalRevenueColumn |
| Related Or Exempt Function Income | 89106778 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1206760 | UnrelatedBusinessRevenue |
| Exclusion | $2,951,800 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1384267 | Total |
| Program Services | 311605 | ProgramServices |
| Management And General | 1072662 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30695433 | Total |
| Program Services | 26860158 | ProgramServices |
| Management And General | 3835275 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 992033 | Total |
| Program Services | 898936 | ProgramServices |
| Management And General | 93097 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6667201 | Total |
| Program Services | 5770789 | ProgramServices |
| Management And General | 896412 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2184391 | Total |
| Program Services | 1856732 | ProgramServices |
| Management And General | 327659 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 136877 | Total |
| Program Services | 61764 | ProgramServices |
| Management And General | 75113 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 83903 | Total |
| Management And General | 83903 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 269411 | Total |
| Management And General | 269411 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6827620 | Total |
| Program Services | 5634574 | ProgramServices |
| Management And General | 1193046 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 427073 | Total |
| Program Services | 352447 | ProgramServices |
| Management And General | 74626 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1010759 | Total |
| Program Services | 550503 | ProgramServices |
| Management And General | 460256 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1341992 | Total |
| Program Services | 1337717 | ProgramServices |
| Management And General | 4275 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 163960 | Total |
| Program Services | 53705 | ProgramServices |
| Management And General | 110255 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2384794 | Total |
| Management And General | 2384794 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6431522 | Total |
| Program Services | 497418 | ProgramServices |
| Management And General | 5934104 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 341800 | Total |
| Program Services | 106912 | ProgramServices |
| Management And General | 234888 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 8763633 | 8552491 | 211142 |
| DRUGS | 5134488 | 5118087 | 16401 |
| BAD DEBT | 4675777 | 4675777 | |
| OTHER | 3547072 | 1007901 | 2539171 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2359740 | Total |
| Program Services | 1325631 | ProgramServices |
| Management And General | 1034109 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 85823746 | Total |
| Program Services | 64973147 | ProgramServices |
| Management And General | 20850599 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 458542 | BOY |
| EOY | 10273 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27510972 | BOY |
| EOY | 29347913 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13562309 | BOY |
| EOY | 12224636 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1825816 | BOY |
| EOY | 1761627 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 441357 | BOY |
| EOY | 646744 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 129880034 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 68887427 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63064613 | BOY |
| EOY | 60992607 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78841449 | BOY |
| EOY | 90780478 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 747218 | BOY |
| EOY | 1470168 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 186452276 | BOY |
| EOY | 197234446 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10934100 | BOY |
| EOY | 9758693 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46590353 | BOY |
| EOY | 45663869 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 750000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57524453 | BOY |
| EOY | 56172562 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 128271971 | BOY |
| EOY | 140308395 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 655852 | BOY |
| EOY | 753489 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 128927823 | BOY |
| EOY | 141061884 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 186452276 | BOY |
| EOY | 197234446 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 7764240 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 4369821 | 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 Separate | X | FinancialStatementSeparate |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $7,940 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 7940 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Explanation of Lobbying Activities: | Part II-B, Line 1: | Percentage of AHA dues used for lobbying in 2012 - $5,250 Percentage of WHA dues used for lobbying in 2012 - $2,690 |
| Part IV, Supplemental Information: | Riverview Hospital Association is a member of the Wisconsin Hospital Association (WHA) and American Hospital Assocation (AHA). A portion of the dues paid to these organizations were utilized for lobbying activities. That amount is reported in part II-B. |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2355951 | OtherCostOrOtherBasis |
| Book Value | 2355951 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 66659280 | OtherCostOrOtherBasis |
| Depreciation | 21007344 | Depreciation |
| Book Value | 45651936 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2348781 | OtherCostOrOtherBasis |
| Depreciation | 1602148 | Depreciation |
| Book Value | 746633 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 58461143 | OtherCostOrOtherBasis |
| Depreciation | 46277935 | Depreciation |
| Book Value | 12183208 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 54879 | OtherCostOrOtherBasis |
| Book Value | 54879 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 60992607 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MALPRACTICE INSURANCE LIABILITY | Description |
| Amount | $750,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 750000 | TotalOfAmounts |
| Total Revenue | 93587986 | TotalRevenue |
| Total Expenses | 85823746 | TotalExpenses |
| Excess Or Deficit For Year | 7764240 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 4369821 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 4369821 | TotalAdjustments |
| Excess Or Deficit Per FS | 12134061 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 89164781 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -4118557 | OtherRevenues |
| Revenue Not Rptd F990 | -4118557 | RevenueNotRptdF990 |
| Revenue Subtotal | 93283338 | RevenueSubtotal |
| Investment Expenses Not Included | 269411 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 35237 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 304648 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 93587986 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 81400541 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 557220 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 557220 | ExpensesNotRptdF990 |
| Expenses Subtotal | 80843321 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 269411 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 4711014 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 4980425 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 85823746 | 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 income tax positions, the Association 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 financial statements. The Association is also engaged, to a limited extent, in activities that the Internal Revenue Service (IRS) considers unrelated to its exempt purpose and, therefore, taxable. If these activities result in net operating income for income tax purposes, the Association recognizes the anticipated tax liability and expense. If these activities result in net operating losses for income tax purposes, the Association does not recognize the tax benefit from the net operating losses that would be realized in the future unless it can be determined that it is reasonable that such an estimated benefit will be realized in the future. Currently, any potential deferred tax asset resulting from the availability of net operating loss carryforwards is offset by a valuation allowance of equal amount. No deferred tax assets and liabilites have been recognized since no other differences exist between the financial tax bases of reporting the Association's assets and liabilities. The Association's policy is to recognize interest and penalties related to income tax matters in income tax expense when incurred. In 2012 and 2011, there were no payments of income tax, tax penalties, or interest related to tax penalties recorded by the Association in the financial statements. The Association recorded no assets or liabilities for uncertain tax positions or unrecognized tax benefits in 2012 and 2011. Federal returns for years ended August 31, 2011, 2010 and 2009 remain subject to examination by the Internal Revenue Service. |
| Part XII, Line 2d - Other Adjustments: | MEDICAL BUILDING RENT NET WITH REV 467,406. RENT EXPENSES NET WITH REV 89,814. PROVISION FOR BAD DEBTS - FASB ISSUED ASU 2011-07 -4,675,777. | |
| Part XII, Line 4b - Other Adjustments: | GAIN ON DISPOSAL OF ASSETS 35,237. | |
| Part XIII, Line 2d - Other Adjustments: | MEDICAL BUILDING RENT NET WITH REV 467,406. RENT EXPENSES NET WITH REV 89,814. | |
| Part XIII, Line 4b - Other Adjustments: | GAIN ON DISPOSAL OF ASSETS 35,237. PROVISION FOR BAD DEBTS - FASB ISSUED ASU 2011-07 4,675,777. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Love Lights | NameOfEvent1 |
| Gross Receipts Event1 | 35410 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 35359 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 51 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 51 | OtherDirectExpensesEvent1 |
| Name Of Event2 | Christmas at the Ridges | NameOfEvent2 |
| Gross Receipts Event2 | 13895 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 9519 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 4376 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 4376 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 49305 | GrossReceiptsTotal |
| Charitable Contributions Total | 44878 | CharitableContributionsTotal |
| Gross Revenue Total Events | 4427 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 4427 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 4427 | DirectExpenseSummaryEvents |
| Net Income Summary | 0 | NetIncomeSummary |
Gaming Information GamingInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Revenue Other Gaming | 5071 | GrossRevenueOtherGaming |
| Other Direct Expenses Other Gaming | 2285 | OtherDirectExpensesOtherGaming |
| Volunteer Labor Other Gaming | 1 | VolunteerLaborOtherGaming |
| Volunteer Labor Prcnt Other Gaming | 1.00000 | VolunteerLaborPrcntOtherGaming |
| Gross Revenue Total Gaming | 5071 | GrossRevenueTotalGaming |
| Other Direct Expenses Total Gaming | 2285 | OtherDirectExpensesTotalGaming |
| Direct Expense Summary Gaming | 2285 | DirectExpenseSummaryGaming |
| Net Gaming Income Summary | 2786 | NetGamingIncomeSummary |
| Field | Value | IRS element (for citing) |
|---|---|---|
| States Where Gaming Conducted | WI | StatesWhereGamingConducted |
| Licensed | 1 | Licensed |
| License Suspended Etc | 0 | LicenseSuspendedEtc |
| Gaming With Nonmembers | 1 | GamingWithNonmembers |
| Member Of Other Entity | 0 | MemberOfOtherEntity |
| Percentage Of Gaming Own Facility | 1.00000 | PercentageOfGamingOwnFacility |
| Name Of Gaming Rec Keeper Person | Dianne Pokrandt | NameOfGamingRecKeeperPerson |
Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5849 Sarah Circle | AddressLine1 |
| City | Wisconsin Rapids | City |
| State | WI | State |
| ZIP Code | 54494 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contract With3rd Party For Gam Rev | 0 | ContractWith3rdPartyForGamRev |
| Gaming Manager Name Person | Elaine Semrow | GamingManagerNamePerson |
| Gaming Manager Services Provided | Treasurer of Auxiliary Fundraising Events | GamingManagerServicesProvided |
| Gaming Manager Is Director Officer | X | GamingManagerIsDirectorOfficer |
| Charitable Distrib Required | 0 | CharitableDistribRequired |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| 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 | 1113334 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1113334 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01370 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14863351 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14433778 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 429573 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00530 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15976685 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14433778 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1542907 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01900 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 712110 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 228557 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 483553 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00600 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 100124 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 100124 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3671027 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2436740 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1234287 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01520 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 54869 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 17810 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 37059 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4538130 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2683107 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1855023 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02290 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 20514815 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 17116885 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3397930 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04190 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,305,868 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 16789722 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 20146229 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3356507 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Riverview Hospital Association | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 410 Dewey Street | AddressLine1 |
| City | Wisconsin Rapids | City |
| State | WI | State |
| ZIP Code | 54495 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| 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 | RIVERVIEW HOSPITAL ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Available On Request | X | AvailableOnRequest |
| 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 |
|---|---|---|---|---|
| UW Cancer Center Riverview | ||||
| 410 Dewey Street | Wisconsin Rapids | WI | 54495 | Cancer Center |
| Riverview Family Clinic Wisconsin Rapids | ||||
| 420 Dewey Street PO Box 8080 | Wisconsin Rapids | WI | 54495 | Clinic |
| Riverview Family Clinic Nekoosa | ||||
| 1015 Angelus Drive | Nekoosa | WI | 54457 | Clinic |
| Riverview Family Clinic Lakes Area | ||||
| 1160 Rome Center Drive Town of Rome | Nekoosa | WI | 54457 | Clinic |
| Riverview Community Dental Clinic | ||||
| 820 Two Mile Avenue | Wisconsin Rapids | WI | 54494 | Dental Clinic |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 7: Riverview Hospital utilizes a cost to charge ratio to report the information in Part I except for the Subsidized Health Services. See comment in Part I, Line 7g for costing method used to calculate the Subsidized Health Services community benefit expense. All amounts in Part I, line 7f were reduced by the bad debt amount of $4,675,777. | ||
| Part I, Line 7g: The above costs of Subsidized Health Services are related to the Dental Clinic, Lakes Family Clinic, and Nekoosa Family Clinic. Riverview Hospital utilized an internal departmental financial statement to report the cost and direct offsetting revenue that calculates the community benefit expense. The Dental Clinic reported costs of $340,959 with offsetting revenue of $287,138. The Lakes Family Clinic reported costs of $1,401,855 with offsetting revenue of $847,333. The Nekoosa Family Clinic reported costs of $1,928,213 with offsetting revenue of $1,302,369. None of the costs indicated above are attributable to a physician clinic. | ||
| 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 $ 4675777. | ||
| Part II: Riverview Hospital Association collaborates with community partners to perform a needs assessment to drive the development of programs provided to the community. Initiatives include: Improving access to dental care, preventing obesity through policy development and environmental change, and reducing at-risk behavior in teens. The Association also offers low-cost lab screenings, childbirth education, cancer education, and Ask-a-Nurse assistance.The information needed to complete the total community building expense for the table in Schedule H Part II is difficult to obtain, although the activites we provide to the communinity are explained above. | ||
| Part III, Line 4: Riverview Hospital applies cost to charge ratio to bad debt expense as reported on the financial statements. The carrying amounts of accounts receivable are reduced by allowances that reflect management's best estimate of the amounts that will not be collected. Management provides for uncollectible amounts under terms of third-party reimbursement agreements through a reduction of gross revenue and a credit to accounts receivable. In addition, management provides for probable uncollectible amounts, primarily from uninsured patients and amounts for which patients are personally responsible, through a charge to operations and a credit to a valuation allowance based on its assessment of historical collection likelihood and a current status of individual accounts. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to accounts receivable. | ||
| Part III, Line 8: Amount of Medicare allowable costs was taken directly from the Medicare cost report.Whether there is a shortfall or surplus on services to Medicare beneficiaries, these patients, who are typically elderly members of the community, are an underserved population who experience issues with access to healthcare services. Without tax-exempt hospitals providing Medicare patient services, the centers for Medicare and Medicaid (CMS) would bear the burden of directly providing services to the elderly and disabled members of the community. The total Medicare revenue shown on Schedule H is based on the IRS 990 Instructions and includes only the charges from Medicare program beneficiaries that are reported on the hospital's Medicare Cost Report. The amount listed for Medicare revenue does not include physician services for the coverage of the emgerency department at Riverview Hospital, physician services provided at the outlying clinic locations, and a significant portion of lab services which are reimbursed by the Medicare program under another methodology. Physician coverage and outpatient lab services are reimbursed primarily on a fee schedule reimbursement at rates that are often below the costs of caring for patients. Emergency physician services provided to Medicare patients are vital to the well-being of the community and as such these costs and shortfalls should also be considered as an additional benefit that Riverview Hospital provides to the community and the surrounding areas. The costing method used above for IRS 990 compliance reporting is also based on the overall average cost to charge ratio and does not consider Medicare non-allowable expenses as it is based on total operating expenses less the provision for bad debt expense divided by the hospital patient service revenue (ignoring contractual adjustments on fee schedule reimbursed items and non-allowable Medicare expenses as noted above). This ratio is then multiplied by the total Medicare services, which are reimbursed based on Medicare regulations. Including the fee schedule items, such as physician services, would produce a larger loss or shortfall on these services to be reported on the Form 990 in any given year. | ||
| Part III, Line 9b: For patients qualifying for financial assistance patients will only be billed if they have not provided current proof of eligibility, a spenddown has not been met or there is a private third party payor also on the patient's record.For patients qualifying for charity care, arrangements for reduced or free care are made with a financial counselor. Should the patient default on this arrangement, standard collection practices would apply. | ||
| Part V, Section B, Line 19d: Per Policy #0260110 the discount will be determined annually at the start of the fiscal year and will be the average discount offered on our commerical insurance contracts. | RIVERVIEW HOSPITAL ASSOCIATION | |
| Part VI, Line 2: RHA actively participates in Healthy People Wood County (HPWC). The purpose of HPWC is to establish priorities and recommend strategies to enhance the quality of life, health status, and the environment in Wood County. In order to accomplish this, multiple partners work together to analyze health data, quality of life indicators and the community's perception of health. | ||
| Part VI, Line 3: Community Care information is provided on both the website (riverviewhospital.net) and the back of the patient statement. Financial Counselors offer Community Care applications to patients whom they discover during conversations of attempting to establish payment plan arrangement would potentially meet the program qualifications. | ||
| Part VI, Line 4: Riverview Hospital Association owns and operates the following entities: (1) Riverview Hospital, established in 1912; (2) the outpatient Riverview Rehabilitation Center; (3) Riverview Family Clinic, This service includes clinics in Wisconsin Rapids, Nekoosa, and the Rome-Lakes area; (4) the UW Cancer Center Riverview. UWCC-R opened in 2003 in cooperation with UW Comprehensive Cancer Center, Madison; and (5) Riverview Community Dental Clinic. RHA established this clinic in 2009 to serve residents of South Wood County. Riverview Dental Clinic in Wisconsin Rapids is open to patients who have Medicaid or Badger Care insurance coverage. This insurance is not typically accepted by independent dental clinics. Approximately 4,301 persons benefited from this program in 2012.While many Riverview patients come from Wood County, an increasing number are coming to us from surrounding counties - specifically those along the Interstate 39 corridor: Marathon, Portage, Waupaca, Adams, Juneau, Waushara, Marquette, Columbia, Sauk, and Dane. For the Hospital, over 12.3% of all admissions between July 2011 and June 2012 came from the counties alongside this corridor. For the UW Cancer Center-Riverview over the same period, over 16% of all patients came from these same counties-not including our "home" county of Wood.In the Riverview "service area" there are several federally designated "medically underserved areas." They are Wood County (the central part between Marshfield and Wisc. Rapids), Portage County (part), Adams County (all), Waushara County (all), Marquette County (all), Juneau County (about half, the Northern half), Marathon County (part), and Clark County (all). We have scattered Indian tribal lands in Wood County, Juneau County, and Adams County (all Ho Chunk). These would be considered "medically underserved populations" per federal designation.Other hospitals in our service area include: St. Joseph's Hospital in Marshfield, St. Michael's Hospital in Stevens Point, Moundview Memorial Hospital in Friendship, and Hess Memorial Hospital in Mauston. | ||
| Part VI, Line 5: SEE ABOVE FOR ADDITIONAL DETAIL | ||
| WI | Reports Filed With States | Part VI, Line 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | 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 (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MERCEDES DE LAS ALAS MD | |||||||||||||
| 251852 | 0 | 13641 | 0 | 630 | 0 | 23901 | 0 | 21581 | 0 | 311605 | 0 | 0 | 0 |
| CELSE BERARD | |||||||||||||
| 292261 | 0 | 0 | 0 | 1224 | 0 | 28175 | 0 | 22283 | 0 | 343943 | 0 | 0 | 0 |
| PEGGY OSE | |||||||||||||
| 159408 | 0 | 0 | 0 | 2178 | 0 | 11403 | 0 | 22496 | 0 | 195485 | 0 | 0 | 0 |
| MICHAEL BOVEE | |||||||||||||
| 193420 | 0 | 0 | 0 | 630 | 0 | 13679 | 0 | 23176 | 0 | 230905 | 0 | 0 | 0 |
| RICHARD BAILEY MD FACP | |||||||||||||
| 267982 | 0 | 0 | 0 | 533 | 0 | 16500 | 0 | 17314 | 0 | 302329 | 0 | 0 | 0 |
| RONNIE KIRSCHLING MD | |||||||||||||
| 1058284 | 0 | 0 | 0 | 1806 | 0 | 28175 | 0 | 19661 | 0 | 1107926 | 0 | 0 | 0 |
| CRAIG FLINDERS DO | |||||||||||||
| 251386 | 0 | 60329 | 0 | 405 | 0 | 28175 | 0 | 18447 | 0 | 358742 | 0 | 0 | 0 |
| THOMAS FERK DO | |||||||||||||
| 266279 | 0 | 86554 | 0 | 420 | 0 | 28175 | 0 | 22845 | 0 | 404273 | 0 | 0 | 0 |
| JENNIFER MCELROY DO | |||||||||||||
| 266425 | 0 | 13825 | 0 | 276 | 0 | 16500 | 0 | 15622 | 0 | 312648 | 0 | 0 | 0 |
| CHESTON PRICE MD | |||||||||||||
| 258749 | 0 | 4412 | 0 | 388 | 0 | 26435 | 0 | 17477 | 0 | 307461 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 1a | Tax gross-up payments were paid on behalf of Mercedes De Las Alas and Craig Flinders. The amounts paid were as follows: Mercedes De Las Alas - $2.94 Craig Flinders - $.66 Riverview Hospital provided a housing allowance of $300 to Jennifer McElroy. All of the payments above were included in taxable income to the respective employee. Health and social club dues were paid on behalf of Celse Berard and Michael Bovee. The amounts paid were as follows: Celse Berard - $3,576.45 Michael Bovee - $3,390 |
| Part I, Line 4b | The following individuals received payments during the year for a supplemental non-qualifed retirement plan: Kirschling - $8,758 Ferk - $11,770 De las Alas - $11,236 Berard - $15,635 Price - $9,704 Flinders - $9,006 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| Wisconsin Health and Educational Facilities Authority | |||||||
| 391337855 | 97710V8S0 | 2008-04-16 | 27077182 | Hospital addition | 0 | 0 | 0 |
| Wisconsin Health and Educational Facilities Authority | |||||||
| 391337855 | 97710BZW5 | 2010-12-16 | 20296089 | Refinance 2001 Bond | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|
| 1150000 | 24078184 | 2648998 | 350000 | 2009 | 0 | 0 | 1 | 1 |
| 665000 | 18285000 | 1663538 | 347551 | 2010 | 0 | 0 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse |
|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 1 | ||
| 0 | 0 | 0 | 0 | 1 | 0.00900 | 0.00900 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | 2010 CUSIP Identification | ReturnReference |
| Explanation | The Series 2001 Bonds were refinanced in 2010 and each separate principal amount was assigned an individual CUSIP. The CUSIPs range from 97710BZW5 to 97710BA93. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Wood Trust Bank | |||
| Jason Dietz is a board member and a Senior Vice President at Wood Trust Ban | 273329 | Riverview Hospital paid investment management fees to Wood Trust Bank. | 0 |
| Surgical Associates of Wisconsin Rapids SC | |||
| Dr. Marjorie Miller is a board member and is a owner of Surgical Associates | 195200 | Riverver Hospital paid Surgical Associates call pay for physician services. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | Members are those community members who have purchased a membership to Riverview Hospital Association. These are life time memberships once purchased, and each year there is very minimal activity related to the purchase of a membership. | |
| Form 990, Part VI, Section A, line 7a | Members of Riverview Hospital Association are able to nominate and vote candidates to the Board of Directors. | |
| Form 990, Part VI, Section A, line 7b | At the annual meeting with the community members, the members vote whether or not they approve the actions of the board. | |
| Form 990, Part VI, Section B, line 11 | A copy of the 990 is presented to the board at a monthly board meeting and is reviewed in detail with them. Any questions are then answered at that time. Once reviewed, it is then mailed/submitted. | |
| Form 990, Part VI, Section B, line 12c | The Board of Directors of the hospital annually sign their pledge to adhere to the conflict of interest policy here at Riverview Hospital Association (RHA). The signed attestations are filed and maintained by the Compliance Officer. Lisa Rowe-Peplinski, the Vice President - Quality Improvement serves as RHA's Compliance Officer. Over the next year, the hospital is working to further expand the conflict of interest policy to not only include the Board of Directors and administration but also medical staff and department directors. | |
| Form 990, Part VI, Section B, line 15 | The following process describes Riverview Hospital Associations (RHA's) compensation practices: Each non-union and non-physician position is evaluated and assigned to a salary grade based on that evaluation. Evaluation criteria include a position's decision-making impact, thinking challenges, thinking problem solving challenges, work environment and entry qualifications. Each salary grade is assigned a pay range based on the market data for the positions in that salary grade. The entire salary range structure will be reviewed at least annually, and based on market data and the Association's budgetary goal's may be adjusted. Such adjustments will occur on or about the start of the Association's fiscal year. This policy covers all non-physicians and non-union positions within Riverview Hospital Association. In addition, salaries of the CEO, Key Employees, and Physicians are determined in conjunction with an independent compensation consultant and industry studies to determine the proper levels of compensation. These results are approved by the Compensation Committee before finalized. Physician compensation is usually based on market data and productivity via an RVU-based approach. Pay for employees in Riverview's three unions is determined via collective bargaining. All approvals are completed by individuals that do not have a conflict of interest with the transaction. | |
| Form 990, Part VI, Section C, line 19 | Available upon request. | |
| Form 990, Part XI, line 5: | Net unrealized gains on investments: 4,369,821. | Changes in Net Assets or Fund Balances: |
| Form 990, Part XI, Line 2c | The process is consistent with prior years. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVERVIEW HEALTH CARE FOUNDATION INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8080 | AddressLine1 |
| City | WISCONSIN RAPIDS | City |
| State | WI | State |
| ZIP Code | 544958080 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391509239 | EIN |
| Primary Activities | THE FOUNDATION IS OPERATED PRIMARILY FOR THE BENEFIT OF RIVERVIEW HOSPITAL | PrimaryActivities |
| Legal Domicile State | WI | LegalDomicileState |
| Exempt Code Section | 501 (C) 3 | ExemptCodeSection |
| Public Charity Status | Line 11c, III-FI | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Comments