COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC (EIN 39-0987025)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-05-09
IRS object ID: 201341299349302294
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 D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-09T14:44:31-07:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	191 W Nationwide Blvd Suite 500	AddressLine1
City	Columbus	City
State	OH	State
ZIP Code	43215	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	390987025	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Community Memorial Hospital of Menomonee	BusinessNameLine1
Business Name Line2	Falls Inc	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	COMM	NameControl
Phone	4147770960	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	W180 N8085 Town Hall Road	AddressLine1
City	Menomonee Falls	City
State	WI	State
ZIP Code	53051	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Scott R Hawig	Name
Title	Sr. VP Finance & CFO	Title
Date Signed	2013-05-09	DateSigned
Authorize Third Party	false	AuthorizeThirdParty

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Catherine A Jacobson	NameOfPrincipalOfficerPerson
Gross Receipts	317139938	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
All Affiliates Included	false	AllAffiliatesIncluded
Organization501c3	X	Organization501c3
Web Site	www.communitymemorial.com	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1959	YearFormation
State Legal Domicile	WI	StateLegalDomicile
Activity Or Mission Description	To improve quality of life and meet the comprehensive needs of the community by providing high-quality, safe, cost-effective health services while serving our patients with compassionate, dignified and state-of-the art care.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	16	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	1608	TotalNbrEmployees
Total Nbr Volunteers	211	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	114	ContributionsGrantsPriorYear
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	178537645	ProgramServiceRevenuePriorYear
Program Service Revenue CY	177422513	ProgramServiceRevenueCY
Investment Income Prior Year	9028823	InvestmentIncomePriorYear
Investment Income Current Year	5935742	InvestmentIncomeCurrentYear
Other Revenue Prior Year	9591746	OtherRevenuePriorYear
Other Revenue Current Year	22078021	OtherRevenueCurrentYear
Total Revenue Prior Year	197158328	TotalRevenuePriorYear
Total Revenue Current Year	205436276	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	47500	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	50000	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	68218146	SalariesEtcPriorYear
Salaries Etc Current Year	64494413	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	242127	TotalFundrsngExpCurrentYear
Other Expense Prior Year	122229121	OtherExpensePriorYear
Other Expenses Current Year	118794930	OtherExpensesCurrentYear
Total Expenses Prior Year	190494767	TotalExpensesPriorYear
Total Expenses Current Year	183339343	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	6663561	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	22096933	RevenuesLessExpensesCY
Total Assets BOY	307452791	TotalAssetsBOY
Total Assets EOY	308290602	TotalAssetsEOY
Total Liabilities BOY	161666607	TotalLiabilitiesBOY
Total Liabilities EOY	170021753	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	145786184	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	138268849	NetAssetsOrFundBalancesEOY
Mission Description	To improve quality of life and meet the comprehensive needs of the community by providing high-quality, safe, cost-effective health services. Our exceptional employees, volunteers and dedicated medical staff work collaboratively to serve our patients with compassionate, dignified and state-of-the art care.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	92848449	Expense
Revenue	109547171	Revenue
Description	Outpatient Services:Community Memorial had 96,213 outpatient visits in the 12 months ended June 30, 2012. Community offers a wide variety of ancillary, specialty and subspecialty services including: - Allergy/Immunology - Cardiology - Clinical Genetics - Dermatology - Electrophysiology - Endocrinology - Family Practice - Gastroenterology - Gerontology - Gynecologic Oncology - Gynecology - Hand Surgery - Hematology - Infectious Disease - Internal Medicine - Interventional Radiology - Magnetic Resonance Imaging - Neonatology - Nephrology - Neurosurgery - Nuclear Medicine - Occupational Medicine - Oncology - Ophthalmology - Oral Surgery - Otolaryngology - Pathology - Pediatrics - Pedodontics - Perinatology - Periodontics - Physical Medicine and Rehabilitation - Plastic/Reconstructive Surgery - Podiatry - Psychiatry - Psychology - Pulmonary Medicine - Radiology - Radiation Oncology - Rheumatology - Thoracic Surgery - Urology - Vascular Surgery	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	47204257	Expense
Revenue	55693906	Revenue
Description	Inpatient Services:Community Memorial Hospital was founded in 1964 by citizens of the community it serves and specializes in cardiovascular services, women's health, cancer care, and advanced surgical procedures. Combining next-generation technology with personalized care, Community Memorial strives to enhance and improve the quality of life in Waukesha, Washington, Milwaukee and Ozaukee counties.Community Memorial Hospital is licensed for 235 beds of which 202 are staffed - and had 8,835 patient admissions and 40,475 patient days related to a wide range of inpatient services, including women's health, behavioral health, rehabilitation services, general surgery, cardiology, orthopedics, obstetrics and maternity care, pulmonary medicine, and other specialty care for the 12 months ended June 30, 2012.The Heart and Vascular Center is staffed with experienced cardiac professionals utilizing the state-of-the-art technology to treat patients. In 2008, surgeons began using the da Vinci Robotic Surgery system to perform minimally invasive procedures. Minimally invasive surgery offers many advantages over traditional heart surgery, including less scarring, less pain, minimal blood loss (and less need for transfusion), a greatly reduced risk for infection, shorter hospital stay and faster return to normal activities. During fiscal year 2012, Community Memorial cardiac specialists performed 14,565 cardiology procedures.During the year, the Cancer Care Center at Community Memorial received the Outstanding Achievement Award from the American College of Surgeons Commission on Cancer, affirming its commitment to high-quality cancer care. The award recognizes cancer programs that provide the highest quality care to cancer patients and only 66 programs nationally received this award. During fiscal year 2012, Community Memorial had 584 cancer registry cases.The Birthing Center at Community Memorial offers 13 specialty equipped rooms and provides the full spectrum of prenatal services for both normal and high-risk pregnancies. Staffing is provided by leading obstetricians and board-certified neonatologists from the Medical College of Wisconsin. During fiscal year 2012, Community Memorial had 933 births.In addition to the cardiac, cancer care and birthing services, the hospital provided a variety of inpatient ancillary treatments and procedures during the fiscal year including: - Surgeries: 3,367 - Laboratory Tests: 379,752 - CT Scans: 3,701 - Medical Imaging Exams: 15,302 - MRIs: 719 - Nuclear Medicine Scans: 369 - Ultrasounds: 2,516	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	10324570	Expense
Revenue	12181436	Revenue
Description	Emergency Services:Community Memorial's Emergency Department is a Level III Trauma Center and provides 24/7 emergency care for adults and children throughout northern Waukesha, Milwaukee, and Washington counties. During 2012, the emergency department had 20,761 emergency visits, with patients receiving expert care from board-certified emergency physicians and highly trained specialists in trauma, neurosurgery, cardiology, cardiothoracic surgery including robotic surgery, orthopaedics, respiratory, obstetrics, gynecology, psychiatry and other specialties when the need arises. Community Memorial is accredited by the Joint Commission as a certified advanced Primary Stroke Center, demonstrating its ability to provide care from a multi-disciplinary team of neurologists, neurosurgeons, emergency department specialists, radiologists, nurses, therapists, pharmacists, technicians and more all working in a coordinated, collaborative system.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	150377276	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	true	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	true	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	true	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	253	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	1608	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Form990-T Filed	false	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Form8886 T Filed	false	Form8886TFiled
Non Deductible Contributions	false	NonDeductibleContributions
Non Deductible Disclosure	false	NonDeductibleDisclosure
Quid Pro Quo Contributions	false	QuidProQuoContributions
Quid Pro Quo Disclosure	false	QuidProQuoDisclosure
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Number Of8282 Filed	0	NumberOf8282Filed
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Form8899 Filed	false	Form8899Filed
Form1098 C Filed	false	Form1098CFiled
Excess Business Holdings	false	ExcessBusinessHoldings
Taxable Distributions	false	TaxableDistributions
Distribution To Donor	false	DistributionToDonor
Filed Lieu1041	false	FiledLieu1041
Licensed More Than One State	false	LicensedMoreThanOneState
Indoor Tanning Services	false	IndoorTanningServices
Form720 Filed	false	Form720Filed
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	16	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Policies Reference Chapters	false	PoliciesReferenceChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	true	InvestmentInJointVenture
Written Policy Or Procedure	true	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	WI	StatesWhereCopyOfReturnIsFiled
Other Website	X	OtherWebsite
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	David Dirksmeyer	NamePerson
Telephone Number	4147770960	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	N74W127501 Leatherwood Ct	AddressLine1
City	Menomonee Falls	City
State	WI	State
ZIP Code	53051	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	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
Stadelmann Douglas J
Dir & Secretary	1.00	X	X	0	0	0
Pollard Dennis
Dir & President	45.00	X	X	0	525154	146611
Pieters Robert B
Dir & Chair	1.00	X	X	0	0	0
Hart Daniel
Dir & Treas	1.00	X	X	0	0	0
Bast Ronald R
Dir & V. Chair	1.00	X	X	0	0	0
White MD Michael G
Director	1.00	X		0	0	0
Turtenwald Robyn
Director	1.00	X		0	0	0
Templin Susan
Director	1.00	X		0	0	0
Specht-Palmert Christine
Director	1.00	X		0	0	0
Shepherd MD Dennis W
Director	1.00	X		0	0	0
Petasnick William D
Dir/FH CEO	1.00	X		0	6573439	67765
Lux Teresa M
Dir/VP Pat Care	50.00	X		215196	0	47701
Hackett MD James G
Director	1.00	X		0	0	0
Goldberg MD David F
Dir/VP Med Afrs	50.00	X		318793	0	80398
Ellis Sharon Q
Director	1.00	X		0	0	0
Becker Richard C
Director	1.00	X		0	0	0
Van De Kreeke Jeffrey
FH CFO	1.00		X	0	339273	102777
Bestor William E
Former Pres/CEO	0.00			1645153	0	19329	X
Evenson Rock E
VP Pln & Prg Dvlp	50.00			200137	0	61464	X
Freiberg Kerry J
VP Extrnl Affairs	50.00			210401	0	48456	X
McClure Debra
Nurse Anesthetist	50.00			294747	0	18295	X
Sanders Paul A
Sr VP, Clncl Srvcs	50.00			276406	0	36808	X
Zorbini John
Former - Key Employee	0.00			0	299555	110206		X
Jacobson Catherine
Former - Officer	0.00			0	797937	135753		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	3160833	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	8535358	TotalReportableCompFrmRltdOrgs
Total Other Compensation	875563	TotalOtherCompensation
Number Individuals GT100 K	56	NumberIndividualsGT100K
Formers Listed	true	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
Von Briesen & Roper
411 E Wisconsin Ave Ste 700	Milwaukee	WI	53201	Legal	1495015
United Dynacare
9200 W Wisconsin Ave	Milwaukee	WI	53226	Lab	791402
Medical College of WI
8701 Watertown Plank	Milwaukee	WI	53206	Physicians	6931302
Critical Care Solutions
N74W12501 Leatherwood Ct	Menomonee Falls	WI	53051	Virtual ICU	568798
Columbia St Marys
4425 N Port Washington Rd	Glendale	WI	53212	Physicians	1750493

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	15	NumberOfContractorsGT100K
Total Contributions	0	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Outpatient Revenue	900099	109547171	109547171
Inpatient Revenue	900099	55693906	55693906
Emergency/Trauma Revenue	900099	12181436	12181436

Field	Value	IRS element (for citing)
Total Program Service Revenue	177422513	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	4914373	TotalRevenueColumn
Related Or Exempt Function Income	1742607	RelatedOrExemptFunctionIncome
Exclusion	$3,171,766	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	11694	TotalRevenueColumn
Exclusion	$11,694	ExclusionAmount

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	60623	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	34775	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	25848	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	25848	TotalRevenueColumn
Exclusion	$25,848	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	112088025	Securities
Other	560721	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	110871715	Securities
Other	767356	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	1216310	Securities
Other	-206635	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	1009675	TotalRevenueColumn
Exclusion	$1,009,675	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	55426	GrossIncomeFundraisingEvents
Fundraising Direct Expenses	29816	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	25610	TotalRevenueColumn
Exclusion	$25,610	ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Other Dept Operating Rev	561499	1978799	1978799
Corporate Allocated Rev	561000	3482189	3482189
Claims & Settlements	900099	15562935	15562935

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	1002640	TotalRevenueColumn
Exclusion	$1,002,640	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	22026563	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	205436276	TotalRevenueColumn
Related Or Exempt Function Income	200189043	RelatedOrExemptFunctionIncome
Exclusion	$5,247,233	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	50000	Total
Program Services	50000	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	639903	Total
Management And General	639903	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	59457862	Total
Program Services	55670891	ProgramServices
Management And General	3626032	ManagementAndGeneral
Fundraising	160939	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	0	Total

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	151784	Total
Program Services	140810	ProgramServices
Management And General	10564	ManagementAndGeneral
Fundraising	410	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	4244864	Total
Program Services	3937960	ProgramServices
Management And General	295443	ManagementAndGeneral
Fundraising	11461	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	269225	Total
Program Services	269225	ProgramServices

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	2872564	Total
Program Services	2437792	ProgramServices
Management And General	434772	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	11016783	Total
Program Services	9980778	ProgramServices
Management And General	1035088	ManagementAndGeneral
Fundraising	917	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	153600	Total
Program Services	4190	ProgramServices
Management And General	149410	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	1301712	Total
Program Services	572402	ProgramServices
Management And General	722575	ManagementAndGeneral
Fundraising	6735	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	408598	Total
Program Services	60014	ProgramServices
Management And General	347929	ManagementAndGeneral
Fundraising	655	Fundraising

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3506159	Total
Program Services	2878975	ProgramServices
Management And General	621988	ManagementAndGeneral
Fundraising	5196	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	75718	Total
Program Services	36096	ProgramServices
Management And General	39393	ManagementAndGeneral
Fundraising	229	Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	125965	Total
Program Services	108684	ProgramServices
Management And General	17111	ManagementAndGeneral
Fundraising	170	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	2446298	Total
Program Services	2008703	ProgramServices
Management And General	433970	ManagementAndGeneral
Fundraising	3625	Fundraising

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	8693380	Total
Program Services	7138302	ProgramServices
Management And General	1542194	ManagementAndGeneral
Fundraising	12884	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	7483	Total
Program Services	7483	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral	FundraisingFundraising
State Hospital Assessment	5335907	5335907
Provision for Uncollectible	6713000	6713000
Medical Supplies	33781085	33665809	112477	2799
Corporate Allocated Expense	37932736	15365721	22531814	35201

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	4154717	Total
Program Services	3994534	ProgramServices
Management And General	159277	ManagementAndGeneral
Fundraising	906	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	183339343	Total
Program Services	150377276	ProgramServices
Management And General	32719940	ManagementAndGeneral
Fundraising	242127	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	7300	BOY
EOY	7295	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	10956674	BOY
EOY	21754257	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	27698357	BOY
EOY	24095637	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	56000	BOY
EOY	20000	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	3880289	BOY
EOY	4149959	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2556770	BOY
EOY	2126284	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	173808774	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	92431757	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	79311101	BOY
EOY	81377017	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	127517832	BOY
EOY	124482090	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	55468468	BOY
EOY	50278063	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	307452791	BOY
EOY	308290602	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	13245503	BOY
EOY	8803747	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	6648	BOY
EOY	5940	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	66424522	BOY
EOY	63386192	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	81989934	BOY
EOY	97825874	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	161666607	BOY
EOY	170021753	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	144898831	BOY
EOY	137302778	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	887353	BOY
EOY	966071	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	145786184	BOY
EOY	138268849	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	307452791	BOY
EOY	308290602	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	22096933	ReconcilationRevenueExpenses
Reconcilation Other Changes	-29614268	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	FederalGrantAuditRequired
Federal Grant Audit Performed	false	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4674956	BeginningOfYearBalance
Contributions	265167	Contributions
Investment Earnings Or Losses	80003	InvestmentEarningsOrLosses
Grants Or Scholarships	321940	GrantsOrScholarships
Other Expenditures	9357	OtherExpenditures
End Of Year Balance	4688829	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4094065	BeginningOfYearBalance
Contributions	1398548	Contributions
Investment Earnings Or Losses	623704	InvestmentEarningsOrLosses
Grants Or Scholarships	374633	GrantsOrScholarships
Other Expenditures	1066388	OtherExpenditures
Administrative Expenses	340	AdministrativeExpenses
End Of Year Balance	4674956	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3166213	BeginningOfYearBalance
Contributions	904863	Contributions
Investment Earnings Or Losses	384524	InvestmentEarningsOrLosses
Grants Or Scholarships	304571	GrantsOrScholarships
Other Expenditures	56965	OtherExpenditures
Administrative Expenses	-1	AdministrativeExpenses
End Of Year Balance	4094065	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	1.00000	BoardDesignatedEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	true	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	true	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	80711	OtherCostOrOtherBasis
Book Value	80711	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	101701573	OtherCostOrOtherBasis
Depreciation	40471164	Depreciation
Book Value	61230409	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1791466	OtherCostOrOtherBasis
Depreciation	1611450	Depreciation
Book Value	180016	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	33041647	OtherCostOrOtherBasis
Depreciation	22542545	Depreciation
Book Value	10499102	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	37193377	OtherCostOrOtherBasis
Depreciation	27806598	Depreciation
Book Value	9386779	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	81377017	TotalOfBookValueLandBuildings

Other Assets OtherAssets (8 entries)

DescriptionDescription	Book ValueBookValue
Swap Collateral	3617702
Senior Management Deferred Compensation	520601
Rounding	2
Froedtert Health Executive 457f	219735
Executive Deferred Compensation	106062
Due from Employees
Due from Affiliates	445008
Collateral held for securties loaned	33569426

Field	Value	IRS element (for citing)
Total Book Value Other Assets	50278063	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescription	AmountAmount
Swap mark to market	$7,538,027
Pension Liability	$46,632,850
Payable under securities lending agreeme	$33,569,426
Estimated Settlements Due to 3rd Parties	$100,000
Due to Affiliates	$9,985,571

Field	Value	IRS element (for citing)
Total Of Amounts	97825874	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Part X	Part X : FIN48 Footnote	Froedtert Health (FH) applies ASC No. 740, Income Taxes, which clarifies the accounting for uncertainty in income taxes recognized in a company's financial statements. ASC No. 740 prescribes a more likely than not recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken. Under ASC No. 740, tax positions are evaluated for recognition, derecognition, and measurement using consistent criteria and provide more information about the uncertainty in income tax assets and liabilities. As of June 30, 2012 and 2011, FH does not have an asset or liability recorded for unrecognized tax positions.
Part XI, Line 8	Part XI, Line 8: Other Changes in Net Assets or Fund Balances	Transfers to Affiliates $562357 Change in Foundation Restricted Net Assets $78718 Change in APBO than net periodic benefit costs $ -22602174 Capital Contributions $ -1089500 Change in Foundation Unrestricted Net Assets $ -107 Other $ -15599
Part V, Line 4	Part V, Line 4: Intended uses of the endowment fund.	The funds are held by Community Memorial Foundation of Menomonee Falls (CMF), a related organization. The board designated endowment was created to support long range financial needs of Community Memorial Hospital of Menomonee Falls, Inc and its affiliates.

Schedule G IRS990ScheduleG

Field	Value	IRS element (for citing)
Agreement Ref Fundraising	false	AgreementRefFundraising

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	Cheery Cherry Fall Fair	NameOfEvent1
Gross Receipts Event1	38398	GrossReceiptsEvent1
Gross Revenue Event1	38398	GrossRevenueEvent1
Rent Facility Costs Event1	4944	RentFacilityCostsEvent1
Food And Beverage Event1	2862	FoodAndBeverageEvent1
Entertainment Event1	850	EntertainmentEvent1
Other Direct Expenses Event1	7982	OtherDirectExpensesEvent1
Name Of Event2	Special Event Projects	NameOfEvent2
Gross Receipts Event2	6828	GrossReceiptsEvent2
Gross Revenue Event2	6828	GrossRevenueEvent2
Other Direct Expenses Event2	5426	OtherDirectExpensesEvent2
Total Number Of Other Events	1	TotalNumberOfOtherEvents
Gross Receipts Other Events	6781	GrossReceiptsOtherEvents
Gross Revenue Other Events	6781	GrossRevenueOtherEvents
Other Direct Expenses Other Events	5282	OtherDirectExpensesOtherEvents
Gross Receipts Total	52007	GrossReceiptsTotal
Gross Revenue Total Events	52007	GrossRevenueTotalEvents
Rent Facility Costs Total Events	4944	RentFacilityCostsTotalEvents
Food And Beverage Total Events	2862	FoodAndBeverageTotalEvents
Entertainment Total Events	850	EntertainmentTotalEvents
Other Direct Expenses Total Events	18690	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	27346	DirectExpenseSummaryEvents
Net Income Summary	24661	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	true	ExpensesExceededBudget
Unable To Provide Care	false	UnableToProvideCare
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1512065	TotalCommunityBenefitExpense
Net Community Benefit Expense	1512065	NetCommunityBenefitExpense
Percent Of Total Expense	0.00860	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	8024271	TotalCommunityBenefitExpense
Direct Offsetting Revenue	4261470	DirectOffsettingRevenue
Net Community Benefit Expense	3762801	NetCommunityBenefitExpense
Percent Of Total Expense	0.02130	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	9536336	TotalCommunityBenefitExpense
Direct Offsetting Revenue	4261470	DirectOffsettingRevenue
Net Community Benefit Expense	5274866	NetCommunityBenefitExpense
Percent Of Total Expense	0.02990	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	46	NumberOfActivitiesOrPrograms
Persons Served	12636	PersonsServed
Total Community Benefit Expense	1605333	TotalCommunityBenefitExpense
Direct Offsetting Revenue	37544	DirectOffsettingRevenue
Net Community Benefit Expense	1567789	NetCommunityBenefitExpense
Percent Of Total Expense	0.00890	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	4	NumberOfActivitiesOrPrograms
Persons Served	586	PersonsServed
Total Community Benefit Expense	803628	TotalCommunityBenefitExpense
Net Community Benefit Expense	803628	NetCommunityBenefitExpense
Percent Of Total Expense	0.00450	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	16	NumberOfActivitiesOrPrograms
Persons Served	1981	PersonsServed
Total Community Benefit Expense	257490	TotalCommunityBenefitExpense
Net Community Benefit Expense	257490	NetCommunityBenefitExpense
Percent Of Total Expense	0.00150	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	66	NumberOfActivitiesOrPrograms
Persons Served	15203	PersonsServed
Total Community Benefit Expense	2666451	TotalCommunityBenefitExpense
Direct Offsetting Revenue	37544	DirectOffsettingRevenue
Net Community Benefit Expense	2628907	NetCommunityBenefitExpense
Percent Of Total Expense	0.01490	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	66	NumberOfActivitiesOrPrograms
Persons Served	15203	PersonsServed
Total Community Benefit Expense	12202787	TotalCommunityBenefitExpense
Direct Offsetting Revenue	4299014	DirectOffsettingRevenue
Net Community Benefit Expense	7903773	NetCommunityBenefitExpense
Percent Of Total Expense	0.04480	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Building Expense	3616	TotalCommunityBuildingExpense
Net Community Building Expense	3616	NetCommunityBuildingExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Total Community Building Expense	8488	TotalCommunityBuildingExpense
Net Community Building Expense	8488	NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Building Expense	9094	TotalCommunityBuildingExpense
Net Community Building Expense	9094	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Building Expense	4165	TotalCommunityBuildingExpense
Net Community Building Expense	4165	NetCommunityBuildingExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	3	NumberOfActivitiesOrPrograms
Persons Served	176	PersonsServed
Total Community Building Expense	163339	TotalCommunityBuildingExpense
Net Community Building Expense	163339	NetCommunityBuildingExpense
Percent Of Total Expense	0.00090	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	8	NumberOfActivitiesOrPrograms
Persons Served	176	PersonsServed
Total Community Building Expense	188702	TotalCommunityBuildingExpense
Net Community Building Expense	188702	NetCommunityBuildingExpense
Percent Of Total Expense	0.00100	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReported
Bad Debt Expense	$2,723,072	BadDebtExpenseAmount
Amount Reimbursed By Medicare	44804615	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	49276903	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-4472288	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost Accounting System	X	CostAccountingSystem

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	0	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Community Memorial Hospital	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	W180 N8085 Town Hall Road	AddressLine1
City	Menomonee Falls	City
State	WI	State
ZIP Code	53051	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	Community Memorial Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	true	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Information Gaps	X	InformationGaps
Take Into Account	true	TakeIntoAccount
Other Facilities	true	OtherFacilities
CHNA Widely Available	true	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Other Method	X	OtherMethod
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
All Needs Addressed	true	AllNeedsAddressed
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	200.0000	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	400.0000	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Other Factors	X	OtherFactors
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	true	ActionsOnNonpayment
Collection Activities	false	CollectionActivities
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Average Negotiated Rates	X	AverageNegotiatedRates
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (19 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
Part VI - Additional Information	Part V, Line 2: The last year a Needs Assessment was conducted at Community Memorial Hospital of Menomonee Falls was 2012.
Part V - Explanation of Number of Facility Type	Community Memorial Hospital is the only facility listed under this reporting of the IRS Form 990, Schedule H.
Part VI - States Where Community Benefit Report Filed	WI
Part VI - Affilated Health Care System Roles and Promotion	Every year, the Froedtert Health partners engage in a variety of outreach activities in collaboration with key leaders and organizations in their communities that help improve health and quality of life. Much more than the provision of charity care, the American Hospital Association defines community benefit as "promoting and protecting the health and well-being of the entire community through responsive programs and services." In FY2012, Froedtert, Community Memorial and St. Joseph's Hospitals made significant investments in the health of their communities. Patients who couldn't pay for their medical care received more than $49.2 million in uncompensated services. Beyond providing care for the poor, we contributed $76.7 million to improve access to care, teach future healthcare professionals, develop new medical therapies and participate in local partnerships aimed at reducing health disparities.Froedtert Health members develop community benefit strategies and goals based on the unique needs of each of their communities. By conducting regular community needs assessments that monitor critical public health issues, and actively seeking community input, the hospitals have built important local relationships that provide meaningful outreach programs that link each hospital to their neighbors and patients. As a not-for-profit health system, Froedtert Health reinvests its surplus funds back into the community through programs to serve the poor and uninsured, teach future healthcare professionals, develop new medical therapies, manage chronic conditions like diabetes through health education and promotion initiatives, and participate in local partnerships aimed at reducing health disparities. For more information about Froedtert Health, visit www.froedterthealth.org.
Part VI - Explanation Of How Organization Furthers Its Exempt Purpose	The Community Outreach Steering Committee (COSC) which is a subcommittee of the hospital's Board of Directors actualizes the mission of Community Memorial Hospital (CMH) through community benefit activities that improve the quality of life and enhance wellness resources which meet identified comprehensive health needs of the communities served. The Community Outreach Steering Committee is appointed annually by the hospital president and is advisory to the CMH Board and Administration. Membership appointments are made each June with members serving one year terms. The COSC meets quarterly and is composed of hospital and board representatives plus community members representing the various constituencies of the total service area. Functions include: o Provide a leadership role in advocating community wide responses to health care needs in the community. o Facilitate and support community and health care partnerships. o Envision, assess and guide new community benefit opportunities. o Identify and describe unmet health needs. o Promote universal access to health care. o Determine allocation of the Community Outreach Services Fund which awards $50,000 annually towards area non-profits efforts to improve health disparities focused on Access to Care, Mental Health/AODA, Chronic Disease Management and Prevention and Wellness in the communities CMH serves. o Annually submit a community benefit report, which describes the scope of community benefit provided directly and in collaboration with others.Addressing Needs Through Targeted Outreach:Community Memorial Hospital develops and executes community outreach programming and activities based on identified community health needs. Since 1990, CMH conducts needs assessments every three to four yeas in order to determine priorities and strategies in addressing community health disparities. Every needs assessment cycle, CMH Community Outreach staff along with the hospital's Community Outreach Steering Committee develops a community benefit plan which is incorporated into the hospital's overall strategic plan to address the most critical needs in the communities we serve. The plan is reviewed annually by the Community Outreach Steering Committee. CMH Community Outreach staff, leaders and external community partners work collaboratively to develop key goals and strategies to address community health needs. Progress towards community outreach programs/activities and goals are reported quarterly through the Community Outreach Steering Committee and the Board of Directors. Based on the results from the 2012 Community Health Needs Assessment, programs and activities are focused around the following identified health needs: - Access to Primary and Specialty Care - Mental Health/AODA - Chronic Disease Management - Prevention and WellnessFor more information on specific community outreach efforts, please refer to the 2012 Community Memorial Hospital Community Benefit Report by going to www.froedterthealth.org/community-memorial-benefit report.Drug Collection:As part of our commitment to improve the quality of life in our community, Community Memorial Hospital partnered with Waukesha County Drug Free Communities Coalition to host four drug collections since October 2009. At the collections, area residents dropped off over 3,000 pounds of prescription and over-the-counter medications. Close to 2,000 area households participated in the collections. This year alone close to 20 staff contributed over 150 hours of their time to make the collections possible. Flu Clinics:Community Memorial Hospital offers flu clinics for the public as part of its commitment to keep the community healthy. During the fall of FY12, over 100 people were immunized at the six area clinics amounting to a community benefit of close to $8,000. Each of the clinics was staffed by hospital pharmacists who were certified by the state to give immunizations.Athletic Trainer:When athletes at Menomonee Falls and Germantown High Schools prepare to compete, there is a Certified Athletic Trainer with them every step of the way. This service is provided by experienced athletic trainers from Community Memorial Hospital.The trainers work at the school each day, working evenings as well as Saturdays to provide training room, practice and event coverage. They prepare the athlete for their activities, which might include stretching, taping and treatment as needed. United Way Employee Giving Campaign:Community Memorial Hospital collaborates with United Way of Waukesha County to address community needs in the areas of meeting basic needs, developing self-reliance, strengthening communities, and community support. Community Memorial Hospital hosts an annual workplace giving campaign to support all local United Ways. Over 150 hours were spent coordinating the FY12 campaign. In addition to an employee campaign, Community Memorial Hospital matches donations up to $10,000. We also have a staff member that dedicated 50 hours to the United Way of Waukesha County's Leadership and Governance Committee and Executive Committee.Community Health & Wellness Initiative:Froedtert Health Community Memorial Hospital's on-campus garden is providing produce to members of the local community who may not readily have access to fresh vegetables.A community health survey conducted by the hospital in 2011 identified a need for affordable and healthy nutrition options for people who use Community Outreach Health Clinic and clients of area food pantries. The garden project is a great way to help those who have chronic conditions access nutritious vegetables through the hospital's community partners. This fall's harvest, which included tomatoes, cucumbers, zucchini, peppers and beans, was distributed directly to patients who use the outreach clinic and Sussex, Germantown and Menomonee Falls food pantry clients. Over 540 pounds of produce was donated this season.Community Outreach Health Clinic:The Community Outreach Health Clinic is a facility where people can seek medical care. The clinic serves people who do not have medical insurance or the ability to pay for medical care. The clinic provides quality, limited medical care with dignity and confidentiality using the services of volunteer professional staff.In Fiscal Year 2012, the clinic served 2,550 individuals representing a 10% increase compared to the prior fiscal year.Community Health Screenings:Community Memorial Hospital offers free blood pressure, skin cancer and sports injury screenings. With the goal to empower people and the community to make better decisions and take actions to improve and maintain their health, our community health screenings provide much needed access to services for many of our community members. In Fiscal Year 2012, Community Memorial Hospital conducted health screenings for close to 200 people. Bobbie Nick Voss Colonoscopies:Thanks to support of the Bobbie Nick Voss Charitable Foundation, Community Memorial was able to provide free colonoscopies to 20 at-risk individuals without health insurance. Funding from the grant allowed Community Memorial's community health educator to raise awareness about colorectal cancer and the importance of early detection at 28 public events - including flu clinics, health fairs, community events and senior forums.Leadership Quality Indicator:As an indication of the Community Memorial executive team's commitment to the community, 75 hospital leaders provided more than 1,000 hours of support to local initiatives, not-for-profit organizations and community events. Subsidized Transportation Program:The Subsidized Medical Transportation Program at Community Memorial Hospital provides transportation to and from the hospital service locations for eligible persons who have difficulty arranging their own transportation and lack the financial resources to purchase transportation. In 2012, Community Memorial provided 783 free or subsidized rides to 500 people who needed transportation to receive their health care. Community Outreach Steering Committee Grants:Community Memorial's commitment includes grants to local not-for-profit organizations that support community health improvement efforts focused on access to primary care, chronic disease management, mental health and prevention and wellness in the hospital's service area. In 2012, seven local non-profit organizations received grants totaling $50,000 from the Community Outreach Steering Committee. Health Care Career Academy:The Healthcare Career Academy provides qualified students entering their junior or senior year at Menomonee Falls High School, Germantown High School and Sussex Hamilton High School with the opportunity to expand their knowledge base as it relates to a wide array of professional healthcare career options. The three-week program allows students to shadow and learn from professionals in various clinical and ancillary departments throughout the hospital. Through observation, hands-on experience and classro
Part VI - Community Building Activities	To promote the health of our communities, Community Memorial Hospital participates in community building activities which are not included elsewhere on Schedule H. These activities include:1. Economic Development: participation in local chamber of commerce boards focused on economic development.2. Community Support: participation in local emergency preparedness and youth focused coalitions.3. Coalition Building: participation in local community groups and coordination of fundraising for the local United Ways.4. Community Health Improvement Advocacy: participation in creating the community health improvement plan with the local health department.5. Workforce Development: diversity training that recruits health professionals in our traditionally underserved community.
Part VI - Community Information	Since its founding in 1964 by the citizens of the community it serves, Community Memorial Hospital (CMH) has focused on the emerging healthcare and wellness needs of over 400,000 people in the four county region of Waukesha, Washington, and northwest Milwaukee Counties. Based on the US Census data, the population served by CMH is 77% Caucasian, 16% African American, 3% Asian, and 4% other races. 45% of households have a household income less then $50,000. 7% of the population does not have a high school diploma with 28% whose highest education level is a high school diploma. 34% of the population has a Bachelor's Degree or higher education. The most common occupations for our population is 19% manufacturing, 15% sales/office and 13% health care.
Part VI - Patient Education of Eligibility for Assistance	Community Memorial Hospital informs and educates patients regarding financial assistance and government program eligibility in a number of ways. Its communication efforts also address special needs of patients and their families, such as hearing or visual impairment or language interpretation.Information on hospital-based financial support policies and government programs are made available to patients during the pre-registration and registration processes through brochures, signage and direct contact with financial counselors, social workers / case managers and registration staff. Patient billing statements also inform patients that financial assistance is available. The Community Memorial Hospital website contains information regarding pricing, how to understand your hospital bill, and how to apply for Financial Assistance. Community Memorial Hospital has made financial assistance forms and information available in Spanish. Financial counselors screen uninsured patients for government program eligibility and social services staff are available to assist patients with enrollment processes. Patients who are uninsured, those covered by government programs and those with limited financial means may also be eligible for charity care or discounts through the Hospital's financial assistance program. Financial counselors make every effort to determine a patient's eligibility prior to or at the time of admission or service. However, determination for financial assistance can be made during any stage of the patient's stay after stabilization, or the collection cycle.
Part VI - Needs Assessment	In February, 2012 Froedtert Health Community Memorial Hospital collaborated with JKV Research, LLC along with Aurora Health Care, Children's Hospital of Wisconsin, Columbia St. Mary's Health System, ProHealth Care, Wheaton Franciscan Healthcare, Washington County Health Department and Waukesha County Health Department to conduct a Community Health Needs Assessment (CHNA) in Washington and Waukesha Counties. The research from the needs assessment provides valuable behavioral data, lifestyle habits, and the prevalence of risk factors and disease conditions of Waukesha County residents. CHNA Overview/Objectives: o Gather data on behavioral and lifestyle habits of the adult population and household-level data. o Gather data on the prevalence of risk factors and disease conditions of the adult population. o Compare health data of residents to previous health studies. o Compare health data to national and state measurements.CHNA Methodology: o 18 minute telephone survey of area residents o 400 completions from February 21 through April 3, 2012 o Two-fold sampling 1) RDD landline sample of listed & unlisted #s (n=300) o Respondents randomly selected based on number of adults in household o Weighting based on number of adults and number of residential phone numbers in household. 2) Cell phone only sample (n=100) o Adult answering the phone designated as the respondent o All data post-stratified by age and gender of adult residents as of 2010 Census proportions. o Margin of error: 5%The full report of the findings can be found at www.communitymemorial.com. In addition to the Washington/Waukesha County Community Health Needs Assessments, Community Memorial Hospital conducted key informant interviews with 35 individuals representing school district representatives, public health officials, non-profit health and human service professionals, churches, police/fire departments, free clinics and business professionals throughout Waukesha and Washington Counties. Following extensive interviews with key community stakeholders, findings from the assessment were categorized into eight areas: Access to Primary and Specialty Care, Chronic Disease Management, Mental Health Services, Prevention and Wellness, Alcohol, Drug, Tobacco, Abuse, Dental Services, Transportation and Other. Of those eight health needs categories, four were identified as the focus for community outreach activities in 2012 through 2016 based on select criteria: Community Health Priorities, Disproportionate Unmet Needs, Public Health Concerns and Scope of Services. The most critically documented health needs were identified: - Access to Primary and Specialty Care - Mental Health - AODA - Prevention and Wellness - Chronic Disease ManagementIn April 2011, Community Memorial Hospital Community Outreach Staff participated in the Waukesha County Public Health Department's Community Health Improvement Planning Process (CHIPP). The CHIPP consists of a steering committee representing all health systems in Waukesha County as well as representation from area non-profit health and human service agencies. The steering committee's role is to determine the top health priorities in the county and create an implementation plan to address community and health needs for Waukesha County Public Health Department to execute in 2012 - 2016. Through the work of the CHIPP Steering Committee, the following priorities have been determined: - Access to Care - Mental Health - AODAImplementation plans are currently being developed for the three priority areas and will be presented for adoption/implementation at the February 2013 Waukesha County Board Meeting.
Part V, Line 13g - Other Means Hospital Facility Publicized the Policy	Community Memorial Hospital's Community Benefit Fact Sheet, which is available on its website and distributed to community stakeholders, includes highlights of Froedtert Health's financial assistance and billing highlights.	Number of Hospital Faciltiy - 0
Part V, Line 11h - Other Factors Used in Determing Amounts Charged Patients	Out of Pocket Maximum Discount	Number of Hospital Faciltiy - 0
Part V, Line 5c - Description of Making Needs Assessment Widely Available	The Community Health Needs Assessments for both Waukesha and Washington Counties are available through Community Memorial Hospital's website at www.communitymemorial.com and is also shared with hospital partners and supporting agencies.	Number of Hospital Faciltiy - 0
Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment	Washington County Health Needs Assessment Collaboration:JKV ResearchFroedtert Health Froedtert Health Community Memorial HospitalAurora Health CareColumbia St. Mary's Health SystemChildren's Hospital of WisconsinWashington County Public Health DepartmentWaukesha County Health Needs Assessment Collaboration:JKV ResearchFroedtert Health Froedtert Health Community Memorial HospitalAurora Health CareColumbia St. Mary's Health SystemProHealth CareWheaton Franciscan HealthcareWaukesha County Public Health Department	Number of Hospital Faciltiy - 0
Part V, Line 3 - Account Input from Person Who Represent the Community	In fiscal year 2012 and in partnership with the Washington County/Waukesha County Community Health Needs Assessment, the following individuals/agencies were consulted to provide feedback on identified community health needs:Addiction Resource Council of Waukesha County - Claudia Roska, Executive DirectorAlbrecht Free Clinic - Jenny Zaskowski, Executive DirectorCommunity Outreach Health Clinic at Community Memorial Hospital - Linda Smith, APNPFalls Area Community Services - Kathy Wodushek, Executive DirectorGermantown Area Chamber of Commerce - Lynn Grgich, Executive DirectorVillage of Germantown Fire Department - Mathew Karpinski, CaptainGermantown Police Department - Peter Hoell, Police ChiefGermantown Park & Recreation Department - Brett Altergott, Park and Recreation DirectorGermantown School District - Cindy Dieringer, District NurseGloria Dei Lutheran Church - Julie Pekarske, Parish NurseHartford Jt 1 School District - Joan Schultz, Pupil Service AdministratorHartford Parks and Recreation Department - Mike Herman, DirectorHope Network Inc. - Laura Hensel, DirectorInterfaith Caregivers of Washington County - Debbie Genthe, Executive DirectorInterfaith Senior Programs Waukesha County - Margaret Cory, Mobility ManagerMenomonee Falls Chamber of Commerce - Toni Yates, Executive DirectorMenomonee Falls Community Education & Recreation Department - Joan Erickson, DirectorMenomonee Falls Fire Department - Jeff Hevey, Fire ChiefMenomonee Falls Police Department - Anna Ruzinski, Police ChiefMenomonee Falls School District - Julie Italiano-Thomas, District NursePregnancy Support Connection - Nancy Major, Executive DirectorSt. Boniface Food Pantry - Charlene Matson, CoordinatorSt. Paul's United Church of Christ - Laura Blanco, PastorStillwaters Cancer Support Services - Theresa Reagan, Executive DirectorSussex Area Chamber of Commerce - Kahtryn Wagner, Executive DirectorSussex Area Outreach Services - Aaron Schmalze, Executive DirectorSussex Hamilton School District - Kristin Hasbrook, Student Assistance Program CoordinatorTri-County YMCA in Menomonee Falls - Geoff Mertens, Center ExecutiveUniversity of Wisconsin Extension Washington County - Marma McIntee, Family Living CoordinatorWashington County Mental Health Department - Jim Strachota, DirectorWashington County Public Health Department - Linda Walter, Health OfficerWaukesha County Community Dental Clinic - Renee Ramirez, Executive DirectorWaukesha County Mental Health Department - Mike DeMares - ManagerWaukesha County Public Health Department - CHIPP Subcommittee	Number of Hospital Faciltiy - 0
Part III, Line 9b - Provisions On Collection Practices For Qualified Patients	In alignment with the Froedtert Health financial assistance policy regarding the billing, collection and support for patients with payment obligations, Community Memorial Hospital makes every effort to adhere to the policy and is committed to implementing and applying the policy for assisting patients with limited means in a professional, consistent manner. Staff members who work closely with patients (including those working in patient registration and admitting, financial assistance, customer service, billing and collections) are trained regularly about these policies with an emphasis on treating all patients with dignity and respect regardless of their insurance or their ability to pay for services.
Part III, Line 8 - Explanation Of Shortfall As Community Benefit	Community Memorial Hospital believes that all of the $4,472,288 shortfall should be considered as community benefit. The IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by the hospital in order to continue treating the elderly in our community. The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries.
Part III, Line 4 - Bad Debt Expense	Community Memorial Hospital reports accounts receivable for services rendered at net realizable amounts from third-party payers, patients, and others. Community Memorial Hospital provides an allowance for uncollectible accounts based upon a review of outstanding receivables, historical collection information, and existing economic conditions and trends.The ratio of patient care cost to charges is applied to the bad debt attributable to patient accounts to calculate the estimated cost of bad debt attributable to patient accounts that is reported on line 2. Discounts and payments on patient accounts are recorded as an adjustment to revenue, not bad debt expense. As a not-for-profit, patient care is provided to all, regardless of ability to pay for that care. Making quality patient care available to all in our community, regardless of their economic means, qualifies bad debts as a community benefit.
Part I, Line 7, Column F - Explanation of Bad Debt Expense	Our total expense from Form 990, Part IX, line 25, column (A) was $183,339,343. The bad debt expense included in this amount was $6,713,000. This left us with a total expense of $176,626,343 for the purposes of calculating line 7, column (f).
Part I, Line 7 - Explanation of Costing Methodology	Charity Care and certain other community benefits costs were determined by using internal information to reduce the various activities to cost. We try to present cost information consistently in the different venues that it appears.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Purpose Of GrantPurposeOfGrant	EIN Of RecipientEINOfRecipient
Other Grants 5000
9200 W Wisconsin Avenue	Milwaukee	WI	53226	501(c)(3)	18000	0	Various
Community Outreach Health Clinic
W180 N8085 Town Hall Road	Menomonee Falls	WI	53051	501(c)(3)	32000	0	Support operations of clinic	391743056

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	7	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Grantmaker's Description of How Grants are Used	Identifier
Explanation	Organizations submit grant requests to the Community Outreach Steering Committee (the Committee). On a quarterly basis the fund allocations are determined. Each organization selected for funds receives an award letter detailing the expectations and conditions of the grant money. In order to comply with applicable tax laws, regulations and the Community Outreach Services Fund policy, the Community Outreach Services Fund will provide grant support to organizations with the understanding that:1) Grant funds distributed will be used only for the purposes designated in the award letter.2) No funds will be used for any political campaign or to support attempts to influence legislation of any governmental body. 3) If the organization loses exempt status, any unexpended funds will be returned to the Community Outreach Steering Committee.4) Adequate accounting records of the expenditures of funds will be maintained by the organization.5) This is a one time grant distribution. Future funding requests will be considered on a case by case basis. In addition, the Committee includes a "Final Report Form" with each organization's award letter. The form requires the organization to provide a brief description of the activity and measurable outcomes/benefits, an expenditure report, and future plans. The Committee requests that each organization submit the "Final Report Form" to the Committee within thirty days after the completion of the project for which the funds were intended or within a maximum of one year from the receipt of funds.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	false	WrittenPolicyReTAndEExpenses
Substantiation Required	true	SubstantiationRequired
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	true	SeverancePayment
Supplemental Nonqual Retire Plan	true	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	true	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException
Rebuttable Presumption Procedure	false	RebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs	Base Compensation Filing OrgBaseCompensationFilingOrg	Bonus Filing OrgBonusFilingOrg	Other Compensation Filing OrgOtherCompensationFilingOrg	Deferred Comp Filing OrgDeferredCompFilingOrg	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Total Compensation Filing OrgTotalCompensationFilingOrg	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg
Zorbini John
192008	8817	98730	94954	15252	409761	62
Van De Kreeke Jeffrey
259313	58221	21739	85447	17330	442050
Sanders Paul A
							174886	66101	35419	14032	22776	313214
Pollard Dennis
402248	96197	26709	120442	26169	671765
Petasnick William D
769113	672530	5131796	15925	51840	6641204	4891208
McClure Debra
							269226	5602	19919	5716	12579	313042
Lux Teresa M
							161036	37214	16946	37584	10117	262897	674
Jacobson Catherine
629796	163401	4740	110234	25519	933690
Goldberg MD David F
							254476	55858	8459	50111	30287	399191
Freiberg Kerry J
							169904	32002	8495	37086	11370	258857	137
Evenson Rock E
							153343	27971	18823	37233	24231	261601	162
Bestor William E
							14329		1630824		19329	1664482	1440599

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Sch J, Part III, Additional Information	Part III, Additional Information	Part II, Column (B)(ii): Bonus and incentive compensation amounts include incentive compensation and amounts paid to individuals in lieu of participation in 457(f) deferred compensation plan for the purchase of benefits.
Sch J, Part I, Line 7	Part I, Line 7: Non-Fixed payments not listed above	Certain management employees participate in an incentive compensation plan that includes some non-fixed elements. Upon the attainment of a certain financial threshold, incentive compensation is available for meeting identified goals in the areas of financial performance, operational efficiencies, quality improvements, customer satisfaction, strategic growth and partnership initiatives. In some cases the determination of whether a goal is met is absolute while others require a certain amount of discretion to determine if goal is met. In addition, the incentive compensation includes a purely discretionary component.
Sch J, Part I, Line 1b	Part I, Line 1b: Reason for not following policy regarding payment provisions for expenses	Health club membership subsidy/discount is a benefits program applicable to all employees and is documented in the benefit program documents. Dining club membership is specified in the written employment contract which was approved by the Compensation Committee.
Sch J, Part I, Line 1a	Part I, Line 1a: Relevant information in regards to selections on 1a.	Discounted or subsidized health club membership is available to all employees. Dining Club membership for President used for business purposes. All amounts included in taxable compensation.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Field	Value	IRS element (for citing)
Name Person	Carrie Fitzgerald Hart	NamePerson

Field	Value	IRS element (for citing)
Relationship	See Schedule O	Relationship
Amount Of Transaction	164058	AmountOfTransaction
Description Of Transaction	Employment	DescriptionOfTransaction
Sharing Of Revenues	false	SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
Schedule L - Part IV (b)	Carrie Fitzgerald Hart - Husband, Daniel Hart, is a director.
Part VII - Section A 1a, Column B	Approximate hours per week spent working on related entities:Bast - 2 hoursBecker - 1 hourEllis - 1 hourFreiberg - 1 hourHart - 1 hourJacobson - 49 hoursPetasnick - 53 hoursPieters - 1 hourPollard - 6 hoursTemplin - 1 hourVan De Kreeke - 50 hoursZorbini - 40 hours
Part VII - Section A 1a Columns C-F	Individuals listed as 'former' but receiving compensation during the year is due to the fact the individual is currently, or was during the tax year, still employed by the organization, but is no longer in the role of director, officer, key employee, etc. in the current year, but was reported as such on the organization's 990 in the previous five years.
Part IX 24a Corporate Allocations	Froedtert Health allocates its revenues and expenses to Froedtert Memorial Lutheran Hospital, Community Memorial Hospital of Menomonee Falls, St. Joseph's Community Hospital, Froedtert Physician Partners and West Bend Clinic. The allocation is calculated by applying an allocation metric to each accounting unit at Froedtert Health, including a flat percentage, percentage of gross revenue to total, percentage of supply expense to total, etc. Each entity then receives its portion of the Froedtert Health allocation on a monthly basis.
Part IV, Line 24	Even though the liability is on the books of Community Memorial Hospital of Menemonee Falls, this question was answered no, as Schedule K will be completed on the Form 990 of the parent corporation, Froedtert Health, Inc.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	Comunity Memorial Hospital of Menomonee Fall's quarterly financial information is made available to the public through the Digital Assurance Corporation, Inc. website. Additionally, Governing Documents and Conflict of Interest Policy are made available to the public through the corporate office upon request.	Form 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees	In establishing the compensation of the organizations CEO/Top Management, independent compensation consultants are utilized, compensation studies are completed to gather comparative data, and amounts are reviewed and approved by the Compensation Committee of the Board of Directors.	Form 990, Part VI, Line 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	On an annual basis all officers, directors, trustees, key employees are required to complete a conflict of interest disclosure statement. The data is compiled, and the Vice President-Chief Compliance Officer (CCO), the Vice-President-General Counsel and/or delegate will review all forms and notifications to determine if any conflicts of interest exist in the disclosure documents. If it is determined that a conflict of interest exists, then the person making the disclosure shall be relieved of his/her obligations on behalf of a FH affiliate with respect to the transaction or arrangement that creates the conflict of interest. A report of all conflicts of interest will be made by the CCO at least annually to the Finance Committee of the Board of Directors.	Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11: Form 990 Review Process	Froedtert Health accounting staff prepare Form 990 which is reviewed by the Corporation's financial leaders and legal counsel. The 990 is then reviewed by KPMG, the Corporation's outside accounting firm. Next, the 990 is provided to the Corporation's Finance Committee and Board of Directors. Finally, the 990 is filed as required.	Form 990, Part VI, Line 11
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders	As the sole corporate member of Froedtert Memorial Lutheran Hospital, Community Memorial Hospital of Menomonee Falls, St. Joseph's Community Hospital of West Bend, West Bend Clinic and Froedtert Physician Partner's, Froedtert Health (FH) retains certain reserved powers over each of these affiliates (the Affiliated Entities). The corporate Bylaws of FH and the Affiliated Entities provide that FH has the authority to direct the activities of FH and the Affiliated Entities, including the following:a) Develop and revise FHs Strategic and Financial Plan, and approve, develop or revise any strategic plans relating to the Affiliated Entities;b) Approve, develop or revise capital and operating budgets for FH and the Affiliated Entities;c) Approve all requests by FH and the Affiliated Entities to borrow or loan funds, incur debt, guarantee a loan, or enter into similar debt obligations in excess of the financial levels specified;d) Make all expenditures of FH and approve all proposed capital expenditures entered into by the Affiliated Entities in excess of the financial levels specified;e) Approve all affiliations, partnerships, joint ventures, acquisitions, divestitures, dissolutions, sales, mergers and similar corporate transactions involving FH and/or an Affiliated Entity;f) Engage in consolidated cash management, transfer and/or consolidate funds of the Affiliated Entities, and direct the members of an obligated group to take actions to cause all the outstanding debt of the obligated group members to be evidenced by notes issued under the same Master Trust Indenture; andg) Develop and revise any capital and operating budget parameters for the Affiliated Entities.	Form 990, Part VI, Line 7b
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body	Froedtert Health, Inc., as the member of Community Memorial Hospital of Menomonee Falls, has the final approval of election of all board members.	Form 990, Part VI, Line 7a
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder	Froedtert Health, Inc. is the member of Community Memorial Hospital of Menomonee Falls.	Form 990, Part VI, Line 6

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	West Bend Surgery Center LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1710 Vogt Drive	AddressLine1
City	West Bend	City
State	WI	State
ZIP Code	53095	ZIPCode

Field	Value	IRS element (for citing)
EIN	391954169	EIN
Primary Activities	Surgical Services	PrimaryActivities
Legal Domicile State	WI	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	West Bend Clinic Inc	BusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg
Froedtert Physician Partners Inc
9200 W Wisconsin Ave	Milwaukee	WI	53226	272042610	Health Care Services	WI	501(c)(3)	3	Froedtert Health Inc	false
QHS 1 Inc
19601 W Bluemound 2nd Flr	Brookfield	WI	53045	202636686	Health Care Services	WI	501(c)(3)	Ln 11, Type 1	Froedtert Health Inc	false
Froedtert Hospital Foundation Inc
9200 West Wisconsin Avenue	Milwaukee	WI	532263596	391431192	Health, Welfare, Research and Education Promotion	WI	501(c)(3)	Ln 11, Type 1	Froedtert Memorial Lutheran Hospital	false
St Josephs Community Foundation Inc
3200 Pleasant Valley Road	West Bend	WI	530953686	392034296	Health and Welfare Promotion	WI	510(c)(3)	Ln 11, Type 1	St Josephs Community Hospital Inc	false
West Bend Clinic Inc
1700 W Paradise Drive	West Bend	WI	53095	392034294	Health Care Services	WI	501(c)(3)	3	Froedtert Health Inc	false
St Josephs Community Hospital Inc
3200 Pleasant Valley Road	West Bend	WI	530953868	390806302	Hospital Care Services	WI	501(c)(3)	3	Froedtert Health Inc	false
Froedtert Memorial Lutheran Hospital Inc
9200 West Wisconsin Avenue	Milwuakee	WI	532263522	396105970	Hospital	WI	501(c)(3)	3	Froedtert Health Inc	false
Community Memorial Foundation
W180 N8085 Town Hall Road	Menomonee Falls	WI	53051	391635057	Health and Welfare promotion	WI	501(c)(3)	Ln 11, Type 1	Community Memorial Hospital of MF	false
Community Outpatient Health Services
W180 N8085 Town Hall Road	Menomonee Falls	WI	53051	391743056	Outpatient Medical and Dental Services	WI	501(c)(3)	3	Community Memorial Hospital of MF	false
Froedtert Health Inc
9200 West Wisconsin Avenue	Milwaukee	WI	532263596	392014409	Management Services	WI	501(c)(3)	Ln 11, Type 111	NA	false

Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner
FHHP LLC
9200 W Wisconsin Ave	Milwaukee	WI	53226	452221564	Health Care	WI	na	false	false
Fitness Development Associates LLC
9200 W Wisconsin Avenue	Milwaukee	WI	53226	391936497	Real Estate	WI	NA	false	false
Milwaukee Center of Diagnostic Imaging
5775 Wayzata Boulevard Suite 400	St Louis Park	MN	55416	411748361	Health Care	WI	NA	false	false
FMLH MCW Real Estate Ventures LLC
9200 W Wisconsin Avenue	Milwaukee	WI	53226	260629591	Real Estate	WI	na	false	false

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Percentage OwnershipPercentageOwnership
Progressive Physician Network Inc
9200 West Wisconsin Avenue	Milwaukee	WI	53226	270367127	Management Services	WI	Froedtert Health Inc	C
Kettle Moraine Anesthesiology Inc
PO Box 8031	Appleton	WI	54912	141842439	Health Care	WI	West Bend Clinic Inc	C
Community Ventures of Menomonee Falls
W180 N8085 Town Hall Road	Menomonee Falls	WI	53051	391635059	Inactive	WI	CMH of MF	C	1.00000

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	true	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	true	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	true	PerformOfServicesByOtherOrgs
Sharing Of Facilities	true	SharingOfFacilities
Sharing Of Paid Employees	true	SharingOfPaidEmployees
Reimbursement Paid To Other Org	true	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	true	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	true	OtherTransferToOtherOrg
Other Transfer From Other Org	true	OtherTransferFromOtherOrg