ST JOSEPHS COMMUNITY HOSPITAL OF WEST BEND INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ST JOSEPHS COMMUNITY HOSPITAL OF WEST BEND INC (EIN 39-0806302)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-10
- IRS object ID
- 201341309349300019
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-10T06:24:30-07:00 | 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 | 390806302 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Josephs Community Hospital | BusinessNameLine1 |
| Business Name Line2 | of West Bend Inc | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STJO | NameControl |
| Phone | 2623345533 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3200 Pleasant Valley Road | AddressLine1 |
| City | West Bend | City |
| State | WI | State |
| ZIP Code | 53095 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Scott R Hawig | Name |
| Title | Sr. VP Finance & CFO | Title |
| Date Signed | 2013-05-10 | DateSigned |
| Authorize Third Party | false | AuthorizeThirdParty |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Catherine Jacobson | NameOfPrincipalOfficerPerson |
| Gross Receipts | 115670890 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.stjosephswb.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1930 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | St. Joseph's Community Hospital of West Bend, Inc is a health care organization dedicated to improving the health status of residents of West Bend and neighboring communitites. Our mission is to provide personalized and trusted care to our patients and their families. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 559 | TotalNbrEmployees |
| Total Nbr Volunteers | 173 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 60411 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 14202 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 77348367 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 84875970 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1038756 | InvestmentIncomePriorYear |
| Investment Income Current Year | 987125 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 3503003 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3659257 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 81950537 | TotalRevenuePriorYear |
| Total Revenue Current Year | 89536554 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 31548608 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 29341296 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 46799571 | OtherExpensePriorYear |
| Other Expenses Current Year | 56577617 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 78348179 | TotalExpensesPriorYear |
| Total Expenses Current Year | 85918913 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3602358 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3617641 | RevenuesLessExpensesCY |
| Total Assets BOY | 121118217 | TotalAssetsBOY |
| Total Assets EOY | 126472402 | TotalAssetsEOY |
| Total Liabilities BOY | 65050656 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 67008680 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 56067561 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 59463722 | NetAssetsOrFundBalancesEOY |
| Mission Description | St. Joseph's Community Hospital of West Bend, Inc is a health care organization dedicated to improving the health status of residents of West Bend and neighboring communitites. Our mission is to provide personalized and trusted care to our patients and their families. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 35675889 | Expense |
| Revenue | 44693500 | Revenue |
| Description | In addition to being a 70-bed hospital, St. Joseph's offers a wide variety of outpatient services to the community, including cancer care services, various diagnostic and therapeutic treatments, outpatient and ambulatory surgeries, and rehab treatments.In 2010, St. Joseph's Hospital's Alyce and Elmore Kraemer Cancer Care Center joined the Froedtert & The Medical College Cancer Network, bringing more cancer expertise to the community. The new St. Joseph's Hospital's 16,000-square-foot Kraemer Cancer Center opened July 9, 2012. Care is conveniently provided close to home, with Medical College specialists working with community physicians to provide advanced, coordinated care, and if needed, access to specialized treatment at Froedtert & The Medical College Clinical Cancer Center in Milwaukee. Cancer network physicians in West Bend include specialists in radiation oncology, urologic oncology, gynecologic oncology and plastic and reconstructive surgery. During the fiscal year, radiation oncology and medical oncology visits totaled 4,301 and 3,298, respectively.Recently, more medical specialties became locally available as the Froedtert & The Medical College Specialty Clinics at St. Joseph's Hospital expanded to include urology, urogynecology, infectious diseases, electrophysiology and cardiology, in addition to the cancer specialties, all of which provide access to leading-edge care to the residents of West Bend and Washington County. In addition to the specialty clinics and cancer care services, St. Joseph's Hospital provided a variety of outpatient treatments and procedures during the fiscal year including:Operations: 2,295CT Scans: 4,129MRIs: 1,822Radiological Diagnostic Exams: 11,073Ultrasounds: 3,181Laboratory Tests: 143,854Nuclear Medicine Scans: 1,685Rehabilitation Treatments: 11,397Ambulatory Surgery Visits: 4,108GI Visits: 679 | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 27894889 | Expense |
| Revenue | 34945737 | Revenue |
| Description | St. Joseph's Hospital is a health care organization dedicated to improving the health status of residents of West Bend and neighboring communities regardless of ability to pay. The hospital has been serving residents of Washington County for more than 80 years and today offers a wide range of inpatient services. In 2005 St. Joseph's opened a new 70-bed hospital that earned national recognition for a design emphasizing patient safety and quality. The 143-acre hospital campus also includes the Kathy Hospice, Froedtert Health West Bend Clinic-South and the Froedtert & The Medical College of Wisconsin Specialty Clinics.St. Joseph's Hospital is an acute care general hospital with 70 licensed and staffed beds, providing a wide range of inpatient services, including general and orthopedic surgery, general medicine, intensive care services, obstetrics and maternity care, and inpatient hospice care.The New Life Center at St. Joseph's Hospital is Washington County's leading birth center, with 652 deliveries and 1,821 patient days during fiscal year 2012. Convenient and comfortable, the center offers experienced nurses, tastefully appointed labor, delivery, recovery and postpartum rooms, a special care nursery and a dedicated C-section suite. The inpatient hospice care unit, the Kathy Hospice, is a separate 8-bed building located on the campus of St. Joseph's Hospital, and provides a peaceful and comfortable environment for individuals in need of end-of-life care. The home-like hospice was the first of its kind in Washington County, and experienced 143 admissions and 2,652 patient days during the fiscal year.In addition to the newborn and hospice services, St. Joseph's Hospital had 2,849 admissions and 10,760 patient days related to medical, surgical and intensive care inpatient services. In conjunction with inpatient stays, the hospital provided a variety of inpatient ancillary treatments and procedures during the fiscal year including, but not limited, to:Operations: 861CT Scans: 1,582MRIs: 238Radiological Diagnostic Exams: 7,616Ultrasounds: 1,831Laboratory Tests: 123,186Nuclear Medicine Scans: 249Rehabilitation Treatments: 23,259 | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4180140 | Expense |
| Revenue | 5236733 | Revenue |
| Description | The Emergency Care Center at St. Joseph's Hospital provides high-quality care for all types of emergencies, 24 hours a day, augmented by its close ties to Froedtert & the Medical College Level I Trauma Center. Staffed by board-certified emergency medicine physicians and emergency certified RNs, the center served more than 16,700 patients in FY 2012. Its designation as a Level III Trauma Center means prompt availability of surgeons and on-call physicians in multiple specialties. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 67750918 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | 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 | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | 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 | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | 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 | false | 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 | 182 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | false | ComplianceWithBackupWitholding |
| Number Of Employees | 559 | 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 | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | 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 | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | 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 | N74 W12501 Leatherwood Ct | AddressLine1 |
| City | Menomonee Falls | City |
| State | WI | State |
| ZIP Code | 53051 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 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 |
|---|---|---|---|---|---|---|---|---|
| Zwygart Christopher | ||||||||
| Director-Chair | 1.00 | X | X | 0 | 0 | 0 | ||
| O'Meara Kristine | ||||||||
| Dir-Vice Chair | 1.00 | X | X | 0 | 0 | 0 | ||
| Olson David | ||||||||
| President | 50.00 | X | X | 0 | 56923 | 2492 | ||
| Laird Michael | ||||||||
| President | 50.00 | X | X | 414441 | 0 | 101574 | ||
| Hauser Mark | ||||||||
| Dir-Treas/Sec | 1.00 | X | X | 0 | 0 | 0 | ||
| Smale Jeffery | ||||||||
| Dir/Doctor | 1.00 | X | 0 | 437055 | 38794 | |||
| Petasnick William D | ||||||||
| Dir/FH CEO | 1.00 | X | 0 | 6573439 | 67765 | |||
| O'Meara Charles | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Martin Mary | ||||||||
| Dir/Pat Care Sv | 40.00 | X | 122126 | 0 | 10826 | |||
| Leitheiser Richard | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Komas Ron | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Jacobson Catherine | ||||||||
| Dir/FH Pres | 1.00 | X | 0 | 797937 | 135753 | |||
| Herdrich Gary MD | ||||||||
| Dir/Doctor | 1.00 | X | 0 | 548632 | 32293 | |||
| Gardner Patrick MD | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Bloedorn Michael | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Bast Ronald | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Van De Kreeke Jeffrey | ||||||||
| FH CFO | 1.00 | X | 0 | 339273 | 102777 | |||
| Arshad Ijaz | ||||||||
| MD-Oncology | 60.00 | 666527 | 0 | 44774 | X | |||
| Herdeman Charles | ||||||||
| Pharmacist | 40.00 | 126154 | 0 | 25636 | X | |||
| Jeuch Thomas | ||||||||
| Pharmacist | 40.00 | 125291 | 0 | 12914 | X | |||
| Lauenstein Debra | ||||||||
| Dir-Human Resource | 40.00 | 139709 | 0 | 10311 | X | |||
| Less Timothy | ||||||||
| Medical Physicist | 40.00 | 179316 | 0 | 35064 | X | |||
| Malzewski Michael | ||||||||
| Former - Officer | 0.00 | 0 | 211863 | 38497 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1773564 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 8965122 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 659470 | TotalOtherCompensation |
| Number Individuals GT100 K | 16 | 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 |
|---|---|---|---|---|---|
| Wheaton Franciscan Services | |||||
| 400 West River Woods Parkway | Milwaukee | WI | 53212 | Laundry Services | 169227 |
| United Dynacare LLC | |||||
| 9200 West Wisconsin Avenue | Milwaukee | WI | 53226 | Laboratory Services | 270363 |
| Medical College of WI | |||||
| 8701 Watertown Plank Rd | Milwaukee | WI | 53226 | Physician Services | 1991546 |
| Diagnostic Services of Washington County | |||||
| 1715 West Paradise Drive | West Bend | WI | 53095 | Pathology Services | 309530 |
| Advanced HRO Solutions Inc | |||||
| 1585 W Oakmont Rd | Hoffman Estates | IL | 60169 | Staffing Services | 263161 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 9 | NumberOfContractorsGT100K |
| All Other Contributions | 14202 | AllOtherContributions |
| Total Contributions | 14202 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Outpatient Revenue | 621400 | 44693500 | 44693500 |
| Inpatient Revenue | 621990 | 34945737 | 34945737 |
| Emergency Dept Revenue | 621990 | 5236733 | 5236733 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 84875970 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 785900 | TotalRevenueColumn |
| Exclusion | $785,900 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 26335536 | Securities |
| Other | 25 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 26081820 | Securities |
| Other | 52516 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 253716 | Securities |
| Other | -52491 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 201225 | TotalRevenueColumn |
| Exclusion | $201,225 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
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 | 900099 | 672775 | 672775 |
| Corporate Allocated Rev | 900099 | 652661 | 652661 |
| Clinic Revenue | 621110 | 1714351 | 1714351 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 619469 | TotalRevenueColumn |
| Related Or Exempt Function Income | 619469 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3659256 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 89536554 | TotalRevenueColumn |
| Related Or Exempt Function Income | 88535227 | RelatedOrExemptFunctionIncome |
| Exclusion | $987,125 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 555180 | Total |
| Management And General | 555180 | 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 | 26807049 | Total |
| Program Services | 24946474 | ProgramServices |
| Management And General | 1860575 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4134 | Total |
| Management And General | 4134 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8514 | Total |
| Management And General | 8514 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1966419 | Total |
| Program Services | 1810124 | ProgramServices |
| Management And General | 156295 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46043 | Total |
| Management And General | 46043 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21870 | Total |
| Program Services | 21870 | ProgramServices |
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 | 6447048 | Total |
| Program Services | 5692303 | ProgramServices |
| Management And General | 754745 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8459 | Total |
| Management And General | 8459 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 393539 | Total |
| Program Services | 245542 | ProgramServices |
| Management And General | 147997 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51265 | Total |
| Program Services | 47617 | ProgramServices |
| Management And General | 3648 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1948368 | Total |
| Program Services | 1211885 | ProgramServices |
| Management And General | 736483 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50698 | Total |
| Program Services | 25482 | ProgramServices |
| Management And General | 25216 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 96902 | Total |
| Program Services | 46482 | ProgramServices |
| Management And General | 50420 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3022960 | Total |
| Program Services | 1880281 | ProgramServices |
| Management And General | 1142679 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5272675 | Total |
| Program Services | 3135095 | ProgramServices |
| Management And General | 2137580 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6971 | Total |
| Management And General | 6971 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| State Hospital Assessment | 2156154 | 2156154 | |
| Provision for Uncollectible | 3738531 | 3738531 | |
| Medical Supplies | 15649922 | 15622422 | 27500 |
| Corporate Allocated Expense | 16787545 | 6771407 | 10016138 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 878667 | Total |
| Program Services | 399249 | ProgramServices |
| Management And General | 479418 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 85918913 | Total |
| Program Services | 67750918 | ProgramServices |
| Management And General | 18167995 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20681 | BOY |
| EOY | 2019 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7419268 | BOY |
| EOY | 5237304 | 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 | 9659269 | BOY |
| EOY | 9398418 | 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 | 550000 | BOY |
| EOY | 250000 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1906352 | BOY |
| EOY | 1873009 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1824544 | BOY |
| EOY | 1386522 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 128917972 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 51590174 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66276290 | BOY |
| EOY | 77327798 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32909261 | BOY |
| EOY | 30780247 | 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 | 552552 | BOY |
| EOY | 217085 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 121118217 | BOY |
| EOY | 126472402 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7053785 | BOY |
| EOY | 6476931 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 115000 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56507472 | BOY |
| EOY | 55822923 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1489399 | BOY |
| EOY | 4593826 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65050656 | BOY |
| EOY | 67008680 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55891204 | BOY |
| EOY | 59315827 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 176357 | BOY |
| EOY | 147895 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56067561 | BOY |
| EOY | 59463722 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 121118217 | BOY |
| EOY | 126472402 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 3617641 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -221480 | 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 B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4814698 | OtherCostOrOtherBasis |
| Book Value | 4814698 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 46759065 | OtherCostOrOtherBasis |
| Depreciation | 8263453 | Depreciation |
| Book Value | 38495612 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3232071 | OtherCostOrOtherBasis |
| Depreciation | 1445776 | Depreciation |
| Book Value | 1786295 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 57576935 | OtherCostOrOtherBasis |
| Depreciation | 41471571 | Depreciation |
| Book Value | 16105364 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 16535203 | OtherCostOrOtherBasis |
| Depreciation | 409374 | Depreciation |
| Book Value | 16125829 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 77327798 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Due to Affiliates | Description |
| Amount | $4,593,826 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4593826 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part X | Part X : FIN48 Footnote | Froedtert Health 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 recogniton, derecogniton, 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, Froedtert Health 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 $316140 Contributions $410 |
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 | 1397306 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1397306 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01700 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7602442 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9860337 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -2257895 | NetCommunityBenefitExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8999748 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9860337 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -860589 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01700 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 17 | NumberOfActivitiesOrPrograms |
| Persons Served | 5616 | PersonsServed |
| Total Community Benefit Expense | 240633 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 240633 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 260 | PersonsServed |
| Total Community Benefit Expense | 286206 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 286206 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00350 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 16 | PersonsServed |
| Total Community Benefit Expense | 49718 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 49718 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 24 | NumberOfActivitiesOrPrograms |
| Persons Served | 5892 | PersonsServed |
| Total Community Benefit Expense | 576557 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 576557 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00700 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 24 | NumberOfActivitiesOrPrograms |
| Persons Served | 5892 | PersonsServed |
| Total Community Benefit Expense | 9576305 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9860337 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -284032 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02400 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 8485 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 8485 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 10192 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 10192 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 12222 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 12222 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 30899 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 30899 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $2,350,918 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 25257421 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 33663350 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -8405929 | 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 | St Josephs Comm Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3200 Pleasant valley Road | AddressLine1 |
| City | West Bend | City |
| State | WI | State |
| ZIP Code | 530953868 | 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 | St Josephs Comm 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 |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| 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 |
| Available On Request | X | AvailableOnRequest |
| 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 (17 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part VI - Additional Information | Part V, Line 2: The last year a Needs Assessment was conducted at St. Joseph's Community Hospital of West Bend was 2012. | |
| Part V - Explanation of Number of Facility Type | St. Joseph's Community Hospital of West Bend 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 fiscal year 2012, 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, 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 | St. Joseph's Community Hospital of West Bend provides healthy community initiatives that support the community. These initiatives include but are not limited to, community education classes, complimentary fitness classes, community volunteering, speakers bureau opportunities and community health fairs.Community Health Education ProgramsSt. Joseph's Hospital regularly schedules educational classes for the community. The services offered are readily accessible to the general public and are free of charge. These programs provide information on a wide variety of health concerns including chronic disease prevention / management. In addition, St. Joseph's Hospital offers a speakers bureau that is a free service to the community. Our knowledgeable health professionals provide credible, up-to-date information on a variety of healthcare topics for groups and organizations. Every 15 MinutesSpeeding, recklessness and drug or alcohol use are common risk factors among children and teens killed in motor vehicle and transport crashes, according to the Wisconsin Child Death Review Council. Changes in behavior can help prevent death and injury from vehicle crashes, one of the top five causes of preventable death in Wisconsin children.To drive home a powerful message about the consequences of drinking and driving and to help prevent death from drunk driving crashes, St. Joseph's Hospital collaborates with the Washington County Injury Prevention Coalition in the "Every 15 Minutes" program. The program involves not only a mock crash but multiple scenarios that are videotaped by high school students and presented at a moving and emotional assembly at school the next day. The hospital has been part of the "Every 15 Minutes" program since 2006, as the receiving hospital for mock crash victims arriving by local EMS ambulance and Flight for Life. The Emergency Care Center provides staffing to treat the mock victims in a realistic way. Physicians, nurses, EMTs, technicians and other staff are involved. Hospital staff are also involved in the planning and communications. In a safe and caring way, the program confronts high school students with the real-life consequences of drunk driving and has been positively received by students and community. United Way Employee CampaignSt. Joseph's Hospital collaborates with the United Way of Washington County to address community needs in the areas of health, education and quality of life. St. Joseph's Hospital hosts an annual workplace giving campaign to support United Way.For more information on specific community outreach efforts, please refer to the 2012 St. Joseph's Hospital Community Benefit Report located at stjosephswb.com.Healthy People Project of Washington CountySt. Joseph's Hospital, through leadership representation on the Healthy People Project of Washington County and the committees dedication, are successfully impacting the health of many in our community. These efforts are being done through collaborative partners, such as Washington County Planning and Parks, Washington County Injury Prevention Coalition, and various local municipalities. The Healthy People Project of Washington County is one of only 118 communities throughout the country (and one of five in Wisconsin) selected as a Pioneering Healthier Communities coalition. Albrecht Free ClinicThe Albrecht Free Clinic provides free medical care to uninsured and underinsured residents of Washington County. Through the support of St. Joseph's Hospital, the clinic is able to serve patients for chronic illness and acute care issues. Services provided by St. Joseph's Hospital at no cost to the patient would be: x-rays, labs, MRI and CT Scans. On an average, over 3,300 patients seek medical services per year. In addition to services related to the patients' direct care, St. Joseph's Hospital provides assistance in providing medical supplies, IT services, and rental space at a cost of $90,772 (4,896 sq ft). Sendik's Healthy Eating ProgramSt. Joseph's Hospital in partnership with Sendik's Food Market, West Bend, offers an educational five-week healthy eating program. The program is designed to help people adopt healthy eating habits in five key areas: fats, carbohydrates, fruits and vegetables, proteins and beverages. The program is offered free-of-charge and presented by a St. Joseph's hospital registered dietitian. In addition to the educational five-week healthy eating program, St. Joseph's hospital is providing monthly health option recipes and tips through our "Let's eat for the health of it!" program. Recipes are critiqued by our registered dietitians. Sexual Assault Nurse Examiner (SANE) Available 24 Hours a DayWhen emergencies take on the even more traumatic element of sexual assault, the specially trained SANE program staff has created a safe haven at St. Joseph's for comprehensive, compassionate care. SANE staff are registered nurses with advanced training in medical-forensic examination and in the psychological and emotional trauma patient's experience. They care for victims of all ages, races and populations to provide timely: - Emotional support - Physical examination and wellness check - Collection of medical-forensic evidence - Assistance with reporting the crime to police, when requested (mandatory reporting for children) - Assistance with concerns about sexually transmitted infection and pregnancy - Assistance with safety planning - Development of a medical follow-up plan SANE nurses are available to speak to groups and organizations. They are also able to serve as expert witnesses if called to testify at a trial.Board of DirectorsThe Board of Directors is made up of medical and business professionals, all of whom reside in the hospital's primary service area. They are dedicated to leveraging the benefits of our community through our hospital's mission. They value the unique character and needs of the patients and communities we serve and the physicians who provide specialty care. St. Joseph's Hospital's community board demonstrates our commitment to quality and service. | |
| Part VI - Community Building Activities | To promote the health of our communities, Froedtert Health St. Joseph's Hospital participates in numerous community building activities that are recognized in the community, which are not part of Part I Charity Care Community Benefits. These activities include:1. Physical Improvements and Housing: contributions toward neighborhood housing improvement for the underserved.2. Coalition Building: collaboration with county service agencies includes work with the Washington County Injury Prevention Coalition on the Every 15 Minutes anti-drunk driving program for teens. Froedtert Health St. Joseph's Hospital's SANE (Sexual Assault Nurse Examiner Program) works closely with volunteers from the area Women's Shelter to care for victims of sexual assault and SANE nurses collaborate with a county coalition to promote awareness, education and prevention of sexual assaults. 3. Economic Development: Leadership participates in local chamber of commerce boards focusing on economic development.4. Diversity: training that recruits health professionals in our traditionally underserved community. 5. Other: Contributions to local organization of equipment, lease space and supplies. | |
| Part VI - Community Information | St. Joseph's Community Hospital of West Bend has been dedicated to serving residents of West Bend and Washington County since 1930 when it was established through the efforts of visionary community leaders and volunteers. As an important part of the community fabric, the hospital continues to meet the changing health and wellness of people who live in and around Washington County. To better serve those needs in a modern, accessible, safe and efficient setting, the hospital built a new replacement facility on US 45 and Hwy PV in August 2005. St. Joseph's Hospital lives its mission to provide personalized, trusted care to its patients and families through strong, locally available services including 24-hour emergency care and cancer care, robust quality and customer service programs and its ability, as a member of Froedtert Health, to link patients with the resources of an academic medical center. An eight bedroom hospice on the hospital campus, the first of its kind in county, has served more than 600 terminally ill patients and their families since 2006.The hospital focuses on the acute and chronic health and wellness needs of residents of Washington County and areas outside the county, with 47,678 residents in its primary service area and 79,158 residents in its secondary service are a total of 126,836 residents (2010 data). The hospital's attention to the changing needs or our patients has led to additions and changes in services. By 2015, the population is expected to grow from 47,678 to 49,122 in the primary service area. Based on the US Census data, the population served by SJH is 96.91% Caucasian, .59% African American, .50% Asian, and 2.00% other races. 36% of households have a household income less than $50,000. 10% of the population does not have a high school diploma and 38% whose highest education level is a high school diploma. 21% of the population has a Bachelor's Degree or higher education. The most common occupations for the population is 27% manufacturing, 15% sales/office and 10% health care. | |
| Part VI - Patient Education of Eligibility for Assistance | St. Joseph's Community Hospital of West Bend 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 Hospital website contains information regarding pricing, how to understand your hospital bill, and how to apply for Financial Assistance. The 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 December, 2011 Froedtert Health St. Joseph's Hospital West Bend collaborated with JKV Research, LLC along with Aurora Health Care, Children's Hospital of Wisconsin, Columbia St. Mary's Health System and Washington County Health Department to conduct a Community Health Needs Assessment in Washington County. The research from the needs assessment provides valuable behavioral data, lifestyle habits, and the prevalence of risk factors and disease conditions of Washington County residents. The methodology of the study included the following data gathering processes: - Gather data on behavioral and lifestyle habits of the adult population and household-level data. - Gather data on the prevalence of risk factors and disease conditions of the adult population. - Compare health data of residents to previous health studies. - Compare health data to national and state measurements.CHNA Methodology: - 18 minute telephone survey of area residents - 400 completions from November 29 through December 19, 2011 - Two-fold sampling 1) RDD landline sample of listed & unlisted #s (n=300) - Respondents randomly selected based on number of adults in household - Weighting based on number of adults and number of residential phone numbers in HH 2) Cell phone only sample (n=100) - Adult answering the phone designated as the respondent - All data post-stratified by age and gender of adult residents as of 2010 Census proportions. - Margin of error: 5%The full report of the findings can be found at www.stjosephswb.com. In addition to the Washington County Community Health Needs Assessment, St. Joseph's Hospital conducted key informant interviews with 26 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 Washington County. 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 Care - Obesity/Nutrition - Lack of Physical Exercise - Chronic Disease Management - AODA - Dental CareWashington County Health Department Community Health Improvement Plan 2011 - 2015St. Joseph's Hospital is a partner with Washington County Public Health Department's Community Health Improvement Plan. The plan which was adopted by the county board in 2012 focuses on the following community health needs: - Improve Dietary Quality - Increase Breastfeeding - Increase Physical Activity - Obesity - Enhance state and community capacity to improve population level health.St. Joseph's hospital is very active in the Health People Project of Washington County's strategic plan with goals to improve access to fruit and vegetable consumption and increase physical activity as a means to decrease obesity. For more information on this initiative please go to www.getmovingwashingtoncounty.com. | |
| 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 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment | Washington County Health Needs Assessment Collaboration:JKV ResearchFroedtert Health St. Joseph's Community Hospital of West BendAurora Health CareColumbia St. Mary's Health SystemChildren's Hospital of WisconsinWashington 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 Community Health Needs Assessment, the following individuals/agencies were consulted to provide feedback on identified community health needs:Albrecht Free Clinic - Jenny Zaskowski, Executive DirectorHartford Jt 1 School District - Joan Schultz, Pupil Service AdministratorHartford Parks and Recreation Department - Mike Herman, DirectorInterfaith Caregivers of Washington County - Debbie Genthe, Executive DirectorUniversity of Wisconsin Extension Washington County - Marma McIntee, Family Living CoordinatorWashington County Mental Health Department - Jim Strachota, DirectorWashington County Public Health Department - Linda Walter, Health OfficerThe Council on AODA - Mary Simon, Executive DirectorVolunteer Center of Washington County - Betsy Wilcox, Executive DirectorEconomic Development of Washington County - Christian Tscheschlok, Executive DirectorSt. Gabriel Church - Sandy Hennes, RNSt. Mary's Catholic Parish Holy Hill - Arlene Barron, RN and Parish NurseWashington County WIC - Carol Birkeland, Executive DirectorKettle Moraine YMCA - Aaron Schmidt, Associate DirectorAging and Disability Resource Center - Linda Olson, ADRC DirectorFriends of Abused Families - Lisa Krenke, Executive DirectorCasa Guadalupe Education Center - Mary Lynn Bennett, Executive DirectorHabitat for Humanity Washington Co. - Russ Wanta, Executive DirectorWest Bend Police Department - Gus Unertl, CaptainWashington County Sheriffs Department - Dale Schmidt, SheriffWest Bend Chamber of Commerce - Craig Farrell, Executive DirectorHartford Area Chamber of Commerce - Barb Laabs, Executive Director | 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, St. Joseph's Community Hospital of West Bend 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 | St. Joseph's Community Hospital of West Bend believes that all of the $8,405,929 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 | St. Joseph's Community Hospital of West Bend reports accounts receivable for services rendered at net realizable amounts from third-party payers, patients, and others. The 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 $85,918,913. The bad debt expense included in this amount was $3,738,531. This left us with a total expense of $82,180,382 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 present cost information consistently in the different venues that it appears. |
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 |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | 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 (11 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 | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Van De Kreeke Jeffrey | ||||||||||||
| 259313 | 58221 | 21739 | 85447 | 17330 | 442050 | |||||||
| Smale Jeffery | ||||||||||||
| 419938 | 17117 | 14700 | 24094 | 475849 | ||||||||
| Petasnick William D | ||||||||||||
| 769113 | 672530 | 5131796 | 15925 | 51840 | 6641204 | 4891208 | ||||||
| Malzewski Michael | ||||||||||||
| 189901 | 20483 | 1479 | 12985 | 25512 | 250360 | |||||||
| Less Timothy | ||||||||||||
| 178504 | 812 | 11088 | 23976 | 214380 | ||||||||
| Lauenstein Debra | ||||||||||||
| 126956 | 1089 | 7045 | 3266 | 150020 | 11664 | |||||||
| Laird Michael | ||||||||||||
| 344432 | 4171 | 76787 | 24787 | 516015 | 65838 | |||||||
| Jacobson Catherine | ||||||||||||
| 629796 | 163401 | 4740 | 110234 | 25519 | 933690 | |||||||
| Herdrich Gary MD | ||||||||||||
| 529784 | 18848 | 15925 | 16368 | 580925 | ||||||||
| Herdeman Charles | ||||||||||||
| 125589 | 565 | 9962 | 15674 | 151790 | ||||||||
| Arshad Ijaz | ||||||||||||
| 624154 | 17373 | 13475 | 31299 | 711301 | 25000 | |||||||
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 partcipate in an incentive compensation plan that includes 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 | Expenses reimbursed pursuant to written contract between St. Joseph's Community Hospital of West Bend and the President, which was approved by the Board of Directors. Each year as part of annual review by Compensation Committee, the expense reimbursement is reviewed. |
| Sch J, Part I, Line 1a | Part I, Line 1a: Relevant information in regards to selections on 1a. | Social club dues reimbursed for organization's President because social club used for business purposes. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part VII - Section A 1a, Column B | Approximate hours per week spent working on related entities:Bast - 2 hoursHerdrich - 61 hoursJacobson - 48 hoursKomas - 1 hourLaird - 1 hourLeitheiser - 1 hourMalzewski - 41 hoursOlson - 2 hoursPetasnick - 53 hoursSmale - 58 hoursVan De Kreeke - 50 hoursZwygart - 1 hour | |
| Part IV, Line 24a | Even though the liability is on the books of St. Joseph's Community Hospital of West Bend, Inc.,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 | Froedtert Health's quarterly financial information, which includes St. Joseph's Community Hospital of West Bend, Inc., is made available to the public through the Digital Assurance Corporation, Inc. website. St. Joseph's Community Hospital of West Bend, Inc. governing documents and conflict of interest policy is made available to the public through the corporate office upon request. | Form 990, Part VI, Line 19 |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | On an annual basis all officers, directors, trustees, and key employees are required to complete a conflict of interest disclosure document. The data is compiled, and the Vice President-Chief Compliance Officer (CCO), the Vice President-General Counsel and/or delegate review all forms and notifications to determine if any conflicts of interest exists 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 Froedtert Health 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 once 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 | Froedtert Health has the following reserved powers over the activities of St.Joseph's Community Hospital:1. Approve any strategic plans; capital and operating budgets; borrowing or loan of funds; debt incurrence; proposed capital expenditures; all affiliations, partnerships, joint ventures, acquisitions, divestitures, dissolutions, sales, mergers and similar corporate transactions;2. Approve amendments to the Articles of Incorporation and Corporate Bylaws and approve appointment of members of Boards of Directors;3. Negotiate managed care contracts;4. Manage and direct investments and engage in consolidated cash management. | Form 990, Part VI, Line 7b |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | Froedtert Health, as the member of St. Joseph's Community Hospital of West Bend, Inc. 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 is the member of St. Joseph's Community Hospital of West Bend, Inc. | Form 990, Part VI, Line 6 |
| Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents | Amended and Restated Corporate Bylaws - effective 7/1/11- Conformance to format for system entities and reserved powers of system parent.- Gives Ex Officio directors the right to vote.- Creates a category of directors emeriti.- Elimates provisions that had expired. | Form 990, Part VI, Line 4 |
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 | Healthcare Services | WI | 501(c)(3) | 3 | Froedtert Health Inc | false |
| Froedtert Health Inc | ||||||||||
| 9200 W Wisconsin Ave | Milwaukee | WI | 53226 | 392014409 | Management Services | WI | 501(c)(3) | Ln 11, type 1 | NA | false |
| Comm Outpatient Health Svcs of MF Inc | ||||||||||
| 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 Inc | false |
| Community Memorial Foundation of MF Inc | ||||||||||
| 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 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 W Wisconsin Ave | Milwaukee | WI | 532263596 | 391431192 | Health, welfare, research, & education promotion | WI | 501(c)(3) | Ln 11, type 1 | Froedtert Memorial Lutheran Hospital | 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 Foundation Inc | ||||||||||
| 3200 Pleasant Valley Road | West Bend | WI | 530953868 | 392034296 | Health and welfare promotion | WI | 501(c)(3) | Ln 11, type 1 | St Josephs Hospital | false |
| Community Memorial Hospital of MF Inc | ||||||||||
| W180 N8085 Town Hall Road | Menomonee Falls | WI | 53051 | 390987025 | Hospital | WI | 501(c)(3) | 3 | Froedtert Health Inc | false |
| Froedtert Memorial Lutheran Hosp Inc | ||||||||||
| 9200 W Wisconsin Ave | Milwaukee | WI | 53226 | 396105970 | Hospital | WI | 501(c)(3) | 3 | Froedtert Health Inc | 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 Avenue | Milwaukee | WI | 53226 | 452221564 | Healthcare | WI | NA | false | false |
| Fitness Development Associates LLC | |||||||||
| 9200 W Wisconsin Ave | Milwaukee | WI | 53226 | 391936497 | Real estate | WI | NA | false | false |
| Milwaukee Ctr for Diagnostic Imag LLC | |||||||||
| 5775 Wayzata Boulevard Ste 400 | St Louis Park | MN | 55416 | 411748361 | Healthcare | WI | NA | false | false |
| FMLH MCW Real Estate Ventures LLC | |||||||||
| 9200 W Wisconsin Ave | 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 |
|---|---|---|---|---|---|---|---|---|
| Progressive Physician Network Inc | ||||||||
| 9200 W Wisconsin Avenue | Milwaukee | WI | 53226 | 270367127 | Management Services | WI | Froedtert Health Inc | C |
| Community Ventures of MF Inc | ||||||||
| W180 N8085 Town Hall Road | Menomonee Falls | WI | 53051 | 391635059 | Inactive | WI | Community Memorial Hosp | C |
| Kettle Moraine Anesthesiology Inc | ||||||||
| PO Box 8031 | Appleton | WI | 54912 | 141842439 | Health Care | WI | West Bend Clinic | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | 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 | true | 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 |