MEMORIAL MEDICAL CENTER INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- MEMORIAL MEDICAL CENTER INC (EIN 23-7013497)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-13
- IRS object ID
- 201202269349302040
- Schema version
- 2010v3.4
- 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 | 2012-08-13T14:32:16-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCGLADREY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 227 W FIRST ST STE 700 | AddressLine1 |
| City | DULUTH | City |
| State | MN | State |
| ZIP Code | 558021919 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237013497 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MEMO | NameControl |
| Phone | 7156855515 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1615 MAPLE LANE | AddressLine1 |
| City | ASHLAND | City |
| State | WI | State |
| ZIP Code | 54806 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LES WHITEAKER | Name |
| Title | VICE-PRESIDENT | Title |
| Phone | 7156855515 | Phone |
| Date Signed | 2012-08-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARY BETH SANTORI | Name |
| Phone | 2187278253 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LES WHITEAKER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1615 MAPLE LANE | AddressLine1 |
| City | ASHLAND | City |
| State | WI | State |
| ZIP Code | 54806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 58126765 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ASHLANDMMC.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1968 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | INPATIENT AND OUTPATIENT MEDICAL SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 424 | TotalNbrEmployees |
| Total Nbr Volunteers | 156 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 71271 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 45164 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 57047294 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 57638141 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 426212 | InvestmentIncomePriorYear |
| Investment Income Current Year | 334471 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 107245 | OtherRevenuePriorYear |
| Other Revenue Current Year | 96013 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 57652022 | TotalRevenuePriorYear |
| Total Revenue Current Year | 58113789 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 27959742 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 28692078 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 22979667 | OtherExpensePriorYear |
| Other Expenses Current Year | 23872840 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 50939409 | TotalExpensesPriorYear |
| Total Expenses Current Year | 52564918 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 6712613 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5548871 | RevenuesLessExpensesCY |
| Total Assets BOY | 62117336 | TotalAssetsBOY |
| Total Assets EOY | 69319088 | TotalAssetsEOY |
| Total Liabilities BOY | 12626394 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 14667319 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 49490942 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 54651769 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | MEMORIAL MEDICAL CENTER WILL REACH OUT AS A TRUSTED PARTNER PROVIDING THE HEALTHCARE SERVICES PEOPLE NEED TO ACHIEVE INDEPENDENT AND PRODUCTIVE LIVES. COLLABORATING WITH OUR COMMUNITIES, WE WILL PROVIDE LEADERSHIP IN INTEGRATING HEALTH SERVICES FOR THE GREATER SOUTH SHORE REGION OF LAKE SUPERIOR. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 44412462 | Expense |
| Revenue | 57734154 | Revenue |
| Description | MEMORIAL MEDICAL CENTER (MMC) IS A CRITICAL ACCESS HOSPITAL WITH OVER 60 FULL-TIME PHYSICIANS ON STAFF AND OVER 400 EMPLOYEES. LOCATED IN THE CITY OF ASHLAND, MMC SERVES AS A REGIONAL MEDICAL REFERRAL CENTER FOR PATIENTS FROM SEVEN NORTHWESTERN WISCONSIN COUNTIES AND THE NEIGHBORING GOGEBIC COUNTY OF MICHIGAN. MMC OFFERS INPATIENT AND OUTPATIENT SERVICES INCLUDING: MEDICAL-SURGICAL; INTENSIVE CARE; OBSTETRICS INCLUDING LABOR, DELIVERY, POSTPARTUM AND RECOVERY (LDPR) SUITES; BEHAVIORAL HEALTH; AND 24-HOUR EMERGENCY CARE. INPATIENT AND OUTPATIENT SURGERIES INCLUDE: ORTHOPEDIC, UROLOGY, OPHTHALMOLOGY, ENT AND OB/GYN IN ADDITION TO GENERAL SURGERY. SUPPORT DIAGNOSTIC SERVICES INCLUDE: LABORATORY; RADIOLOGY WITH MRI, CT AND DIAGNOSTIC ULTRASOUND; NUTRITIONAL SERVICES; PHARMACY; ENDOSCOPY SUITES AND A SLEEP DISORDER CENTER. REHABILITATION SERVICES INCLUDE: CARDIAC REHABILITATION AND CARDIOPULMONARY REHABILITATION; PHYSICAL THERAPY AND SPORTS MEDICINE. LIFELINE EMERGENCY RESPONSE SYSTEM, HOSPICE SERVICES AND SOCIAL SERVICES ARE ALSO AVAILABLE WITHIN MMC. AN ADDITIONAL BUILDING ON THE MMC CAMPUS HOUSES THE BEHAVIORAL HEALTH SERVICES PROVIDING INPATIENT AND OUTPATIENT AODA AND MENTAL HEALTH CARE AND THERAPIES. MMC OPENED AS A PRIVATE, NOT-FOR-PROFIT HOSPITAL IN 1972, COMBINING THE SERVICES PREVIOUSLY PROVIDED BY TRINITY HOSPITAL AND ASHLAND COMMUNITY HOSPITAL, BOTH LOCATED IN ASHLAND. MMC IS THE ONLY HOSPITAL LOCATED IN ASHLAND, BAYFIELD AND IRON COUNTIES. | Description |
| Total Program Service Expense | 44412462 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 52 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 424 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LES WHITEAKER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7156855515 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1615 MAPLE LANE | AddressLine1 |
| City | ASHLAND | City |
| State | WI | State |
| ZIP Code | 54806 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 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 |
|---|---|---|---|---|---|---|---|
| DANIEL HYMANS | |||||||
| PRESIDENT | 40.00 | X | X | 260314 | 0 | 59177 | |
| MATTHEW ANICH | |||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| SCOTT WARREN MD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JOHN OUJIRI MD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| ANNE SULLIVAN | |||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | |
| PATRICIA SCHRAUFNAGEL | |||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| KATHY GANG MD | |||||||
| BOARD MEMBER | 1.00 | X | 16233 | 0 | 0 | ||
| BARBARA BARRY | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| THOMAS JOKINEN | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| CHRIS IVERSON | |||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | |
| DON MARCOUILLER | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| T JAY JONES | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| MARC BARBEAU | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| WILLIAM SLOAN | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| F DANIEL ROCHMAN MD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DANIEL H ADAMS | |||||||
| VICE-PRESIDENT | 40.00 | X | 174245 | 0 | 54807 | ||
| LESLIE J WHITEAKER | |||||||
| VICE-PRESIDENT | 40.00 | X | 185670 | 0 | 46571 | ||
| DANIEL GARDNER | |||||||
| PSYCHOLOGIST | 40.00 | 119823 | 0 | 36877 | X | ||
| WILLIAM MATTILA | |||||||
| PHARMACY-DRTR | 40.00 | 132114 | 0 | 46701 | X | ||
| PATRICK MARSHALL | |||||||
| PHARMACIST | 40.00 | 114850 | 0 | 33937 | X | ||
| KATHRYN TUTTLE | |||||||
| CLINICAL-DRTR | 40.00 | 108722 | 0 | 39744 | X | ||
| STUART SHEETS | |||||||
| PSYCHIATRIST | 40.00 | 180761 | 0 | 27474 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1292732 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 345288 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SUPERIOR ANESTHESIA ASSOCIATES | |||||
| 301 ELLIS AVENUE SUITE 3 | ASHLAND | WI | 54806 | ANESTHESIA SERVICES | 1236855 |
| JAMES LEAN MD | |||||
| 1615 MAPLE LANE | ASHLAND | WI | 54806 | PSYCH PROF FEES | 308406 |
| ESSENTIA HEALTH - ASHLAND | |||||
| 1615 MAPLE LANE | ASHLAND | WI | 54806 | ER ON-CALL SERVICES | 307407 |
| LAKE SUPERIOR LAUNDRY | |||||
| 1701 NORTH 6TH STREET | SUPERIOR | WI | 54880 | LAUNDRY SERVICE | 168481 |
| KEITH HENRY | |||||
| 1615 MAPLE LANE | ASHLAND | WI | 54806 | PATHOLOGY FEES | 130000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Government Grants | 25064 | GovernmentGrants |
| All Other Contributions | 20100 | AllOtherContributions |
| Total Contributions | 45164 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERV REV | 621500 | 56529624 | 56529624 |
| MEDICAID EHR INCENTIVE | 524114 | 890477 | 890477 |
| CAFETERIA | 722210 | 207238 | 207238 |
| OTHER OPERATING REVENU | 900099 | 25302 | 25302 |
| HEALTHY FAMILIES PROGR | 624100 | -14500 | -14500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 57638141 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 295549 | TotalRevenueColumn |
| Exclusion | $295,549 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 96013 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 96013 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 96013 | TotalRevenueColumn |
| Related Or Exempt Function Income | 96013 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 51898 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 12976 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 51898 | Securities |
| Other | -12976 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 38922 | TotalRevenueColumn |
| Exclusion | $38,922 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 58113789 | TotalRevenueColumn |
| Related Or Exempt Function Income | 57734154 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $334,471 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 797017 | Total |
| Program Services | 16233 | ProgramServices |
| Management And General | 780784 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20926693 | Total |
| Program Services | 18542955 | ProgramServices |
| Management And General | 2383738 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 830193 | Total |
| Program Services | 786782 | ProgramServices |
| Management And General | 43411 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4539593 | Total |
| Program Services | 3815460 | ProgramServices |
| Management And General | 724133 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1598582 | Total |
| Program Services | 1374361 | ProgramServices |
| Management And General | 224221 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1311872 | Total |
| Management And General | 1311872 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 97239 | Total |
| Program Services | 82158 | ProgramServices |
| Management And General | 15081 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2973015 | Total |
| Program Services | 2511921 | ProgramServices |
| Management And General | 461094 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 177384 | Total |
| Management And General | 177384 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| OTHER PROFESSIONAL SERV | 7380968 | 7380968 | |
| NURSING SUPPLIES & OTHE | 5059400 | 5059400 | |
| PROVISION FOR BAD DEBTS | 3259784 | 3259784 | |
| CONSULTING | 1639225 | 1639225 | |
| GENERAL SERVICES SUPPLI | 1582440 | 1582440 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 391513 | Total |
| Management And General | 391513 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52564918 | Total |
| Program Services | 44412462 | ProgramServices |
| Management And General | 8152456 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21424633 | BOY |
| EOY | 30871949 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8134870 | BOY |
| EOY | 7608828 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2962990 | BOY |
| EOY | 4364078 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2085670 | BOY |
| EOY | 2016087 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 187293 | BOY |
| EOY | 195212 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 60824749 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 38195439 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19463263 | BOY |
| EOY | 22629310 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7341508 | BOY |
| EOY | 613496 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 517109 | BOY |
| EOY | 1020128 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62117336 | BOY |
| EOY | 69319088 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5684944 | BOY |
| EOY | 6354089 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4691450 | BOY |
| EOY | 6533230 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2250000 | BOY |
| EOY | 1780000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12626394 | BOY |
| EOY | 14667319 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49490942 | BOY |
| EOY | 54651769 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49490942 | BOY |
| EOY | 54651769 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62117336 | BOY |
| EOY | 69319088 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 5548871 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -388044 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 127376 | OtherCostOrOtherBasis |
| Book Value | 127376 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 21168279 | OtherCostOrOtherBasis |
| Depreciation | 14951145 | Depreciation |
| Book Value | 6217134 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 31457594 | OtherCostOrOtherBasis |
| Depreciation | 20981373 | Depreciation |
| Book Value | 10476221 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8071500 | OtherCostOrOtherBasis |
| Depreciation | 2262921 | Depreciation |
| Book Value | 5808579 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 22629310 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | Description |
| Amount | $1,780,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1780000 | TotalOfAmounts |
| Total Revenue | 58113789 | TotalRevenue |
| Total Expenses | 52564918 | TotalExpenses |
| Excess Or Deficit For Year | 5548871 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -388044 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -388044 | TotalAdjustments |
| Excess Or Deficit Per FS | 5160827 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 57725745 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -388044 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | -388044 | RevenueNotRptdF990 |
| Revenue Subtotal | 58113789 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 58113789 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 52564918 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 52564918 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 52564918 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | NOT-FOR-PROFIT ORGANIZATIONS MAY BECOME SUBJECT TO INCOME TAXES IF QUALIFICATION AS A TAX-EXEMPT ENTITY CHANGES, IF UNRELATED BUSINESS INCOME IS GENERATED, AND IN CERTAIN OTHER INSTANCES. NOT-FOR-PROFIT ORGANIZATIONS ARE REQUIRED TO ASSESS THE CERTAINTY OF THEIR TAX POSITIONS RELATED TO THESE MATTERS AND, IN SOME CASES, RECORD LIABILITIES FOR POTENTIAL TAXES, INTEREST AND PENALTIES ACCOMPANIED BY FOOTNOTE DISCLOSURES. THE HOSPITAL HAS NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE THE ACCRUAL OF AN INCOME TAX PROVISION. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 569150 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 569150 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01150 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10566920 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7427453 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3139467 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06370 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 20609282 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 18905077 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1704205 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03460 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 31745352 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 26332530 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5412822 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10980 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17329 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7091 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10238 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5971 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 5971 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10628437 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8549216 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2079221 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04220 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10651737 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8556307 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2095430 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04250 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 42397089 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 34888837 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7508252 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.15230 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $3,259,784 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 16414445 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 16478179 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -63734 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1615 MAPLE LANE | AddressLine1 |
| City | ASHLAND | City |
| State | WI | State |
| ZIP Code | 54806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: COSTS ARE CALCULATED USING FINANCIAL DATA AND THE COST TO CHARGE RATIO FROM THE AS FILED 2011 MEDICARE COST REPORT. | ||
| PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE LABOR & DELIVERY, OBSERVATION BEDS, BLOOD STORING, PHYSICAL THERAPY, IMPLANTABLE DEVICES CHARGED TO PATIENTS, PSYCHIATRIC/PSYCHOLOGICAL SERVICES, CARDIAC REHAB, AND EMERGENCY. | ||
| PART I, L7 COL(F): BAD DEBT EXPENSE FROM FINANCIAL STATEMENTS IS $3,259,784. | ||
| PART III, LINE 4: PATIENT RECEIVABLES DUE DIRECTLY FROM THE PATIENTS ARE CARRIED AT ORIGINAL CHARGE FOR THE SERVICE PROVIDED, LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS AND BY USING HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS. PATIENT RECEIVABLES ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED WHEN RECEIVED.AT MEMORIAL MEDICAL CENTER, INC. BAD DEBT IS CONSIDERED THE UNWILLINGNESS TO PAY, WHILE CHARITY CARE AND FREE CARE ARE INABILITY TO PAY. | ||
| PART III, LINE 8: MEMORIAL MEDICAL CENTER, INC. IS A CRITICAL ACCESS HOSPITAL THAT IS REIMBURSED AT 101% OF COST. THE SHORTFALL REPORTED IS FROM THE PSYCH PROGRAM. IF THIS SERVICE WAS NOT PROVIDED BY THE HOSPITAL, THE NEED FOR THIS SERVICE WOULD NOT BE MET IN THE COMMUNITY. THE MEDICARE FEES FOR REIMBURSED SERVICES RESULTED IN NET REVENUE OF $459,350 AND ALLOWABLE COSTS OF $1,147,252 RESULTING IN A SHORTFALL OF $687,901. THE SHORTFALL IS THE RESULT OF UNREIMBURSED PROFESSIONAL CARE.THE HOSPITAL FOLLOWED MEDICARE'S PRESCRIBED METHODS OF DETERMINING COSTS PAYABLE UNDER TITLE XVIII (MEDICARE) IN COMPLETING ITS ANNUAL MEDICARE COST REPORT (COST REPORT) USING DATA AVAILABLE FROM THE INSTITUTION'S BASIC ACCOUNTS, AS USUALLY MAINTAINED, TO ARRIVE AT EQUITABLE AND PROPER PAYMENT FOR SERVICES. THE COST REPORT WAS COMPLETED USING THE HOSPITAL'S TRIAL BALANCE OF EXPENSES, AS WELL AS OTHER STATISTICAL AND FINANCIAL RECORDS MAINTAINED BY THE HOSPITAL. AS REQUIRED BY MEDICARE REGULATIONS, CERTAIN RECLASSIFICATIONS AND ADJUSTMENTS TO COSTS WERE INCLUDED IN THE COST REPORT TO DETERMINE MEDICARE ALLOWABLE COSTS.AFTER MEDICARE ALLOWABLE COSTS ARE DETERMINED, THE COST REPORT PROVIDES FOR THE STEP DOWN METHOD OF COST FINDING. THIS METHOD PROVIDES FOR ALLOCATING THE COST OF SERVICES RENDERED BY EACH GENERAL SERVICE COST CENTER TO OTHER COST CENTERS, WHICH UTILIZE THE SERVICES. ONCE THE COSTS OF A GENERAL SERVICE COST CENTER HAVE BEEN ALLOCATED, THAT COST CENTER IS CONSIDERED CLOSED. ONCE CLOSED, IT DOES NOT RECEIVE ANY OF THE COSTS SUBSEQUENTLY ALLOCATED FROM THE REMAINING GENERAL SERVICE COST CENTERS. AFTER ALL COSTS OF THE GENERAL SERVICE COST CENTERS HAVE BEEN ALLOCATED TO THE REMAINING COST CENTERS, THE TOTAL COSTS OF THESE REMAINING COST CENTERS ARE FURTHER DISTRIBUTED TO THE DEPARTMENTAL CLASSIFICATION TO WHICH THEY PERTAIN, E.G., HOSPITAL GENERAL INPATIENT ROUTINE, SUBPROVIDER, ANCILLARY, ETC.AFTER THE STEP-DOWN PROCESS, THE COST REPORT PROVIDES FOR THE APPORTIONMENT OF COSTS TO THE MEDICARE PROGRAM BASED ON A NUMBER OF DIFFERENT METHODOLOGIES INCLUDING PER PATIENT DAY, PER VISIT, AND PERCENTAGE OF CHARGES, AS MOST PREVALENT. MEDICARE COSTS AS DETERMINED BY THE COST REPORT METHODOLOGIES DESCRIBED PREVIOUSLY WERE UTILIZED TO COMPLETE THE APPLICABLE MEDICARE ALLOWABLE COSTS OF CARE FOR SCHEDULE H (FORM 990) PART III SECTION B LINE 6. | ||
| PART V, SECTION B, LINE 13G: THE FINANCIAL ASSISTANCE POLICY IS PUBLISHED IN THE LOCAL NEWSPAPER. | MEMORIAL MEDICAL CENTER | |
| PART I, LINE 6A: THE ORGANIZATION FILES AN ANNUAL COMMUNITY BENEFIT REPORT. | ||
| PART VI, LINE 2: MEMORIAL MEDICAL CENTER IS WORKING WITH LOCAL ORGANIZATIONS INCLUDING ASHLAND AND BAYFIELD COUNTY AND LOCAL SENIOR CITIZEN GROUPS TO PUT TOGETHER A 3 YEAR COMMUNITY NEEDS ASSESSMENT. THE PROCESS WILL INCLUDE SURVEYS OF AREA GROUPS AND INDIVIDUALS TO GAIN A PERSPECTIVE OF NEEDS THAT LOCAL CITIZENS BELIEVE ARE NECESSARY TO MEET THE HEALTHCARE NEEDS OF THE AREA. | ||
| PART VI, LINE 3: NOTICES ARE PUBLISHED IN THE LOCAL NEWSPAPER, INTERVIEWS ARE CONDUCTED AT ADMISSION AND FOR THOSE PATIENTS PREADMITTED INFORMATION IS DISTRIBUTED AND INTERVIEWS CONDUCTED TO EXPLORE ALL THE AVENUES AVAILABLE FOR PAYMENT OF THEIR HEALTHCARE SERVICES TO INCLUDE THEIR ELIGIBILITY FOR CHARITY CARE. | ||
| PART VI, LINE 4: MEMORIAL MEDICAL CENTER SERVES AND AREA THAT EXTENDS 25 MILES WEST, 75 MILES EAST AND 45 MILES SOUTH. OUR PRIMARY SERVICE AREA HAS A POPULATION OF APPROX. 35,000 PEOPLE. THE AVERAGE INCOME OF OUR SERVICE AREA IS WELL BELOW STATE AVERAGES. | ||
| PART VI, LINE 6: MEMORIAL MEDICAL CENTER DOES HAVE AN OPEN MEDICAL STAFF WITH A BROAD RANGE OF SPECIALTIES. THE MEMBERS OF THE MEDICAL STAFF PROVIDE SERVICES OUT OF TWO LARGER CLINICS AS WELL AS MANY SMALL INDEPENDENT PRACTICES. ALL HAVE EQUAL PRIVILEGES ON THE MEDICAL STAFF. IN ADDITION WE HAVE A BOARD OF DIRECTORS THAT REPRESENT THE LARGER SERVICE AREA. BOARD OF DIRECTORS COME FROM COMMUNITIES 30-40 MILES FROM ASHLAND AS WELL AS REPRESENTATIVES FROM ASHLAND AND WASHBURN (10 MILES AWAY). | ||
| PART VI, LINE 7: MEMORIAL MEDICAL CENTER IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. | ||
| WI | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DANIEL HYMANS | |||||||||||||
| 260314 | 0 | 0 | 0 | 0 | 0 | 33868 | 0 | 25309 | 0 | 319491 | 0 | 0 | 0 |
| DANIEL H ADAMS | |||||||||||||
| 174245 | 0 | 0 | 0 | 0 | 0 | 29660 | 0 | 25147 | 0 | 229052 | 0 | 0 | 0 |
| LESLIE J WHITEAKER | |||||||||||||
| 185670 | 0 | 0 | 0 | 0 | 0 | 21421 | 0 | 25150 | 0 | 232241 | 0 | 0 | 0 |
| DANIEL GARDNER | |||||||||||||
| 119823 | 0 | 0 | 0 | 0 | 0 | 13282 | 0 | 23595 | 0 | 156700 | 0 | 0 | 0 |
| WILLIAM MATTILA | |||||||||||||
| 132114 | 0 | 0 | 0 | 0 | 0 | 18604 | 0 | 28097 | 0 | 178815 | 0 | 0 | 0 |
| STUART SHEETS | |||||||||||||
| 180761 | 0 | 0 | 0 | 0 | 0 | 22000 | 0 | 5474 | 0 | 208235 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | REGIONAL ENTERPRISES, INC. IS THE SOLE CORPORATE MEMBER OF MEMORIAL MEDICAL CENTER, INC. | |
| FORM 990, PART VI, SECTION A, LINE 7A | REGIONAL ENTERPRISES, INC. MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 MUST GO THROUGH AN ADMINISTRATIVE REVIEW AND THEN BE APPROVED BY THE BOARD OF DIRECTORS BEFORE IT IS FILED. | |
| THE COMPLIANCE OFFICER AND COMPLIANCE COMMITTEE MONITOR AND ENFORCE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. | FORM 990, PART VI, SECTION B, LINE 12C | |
| MMC PARTICIPATES IN SALARY SURVEYS SPECIFIC TO ADMINISTRATOR POSITIONS. THIS INFORMATION IS USED TO DEVELOP SALARY RANGES FOR THE ADMINISTRATIVE STAFF. THE BOARD OF DIRECTORS PARTICIPATES IN DEVELOPMENT OF RANGES AND ESTABLISHMENT OF SALARIES FOR THE THREE SENIOR LEADERS OF THE ORGANIZATION AS DESCRIBED IN CORPORATE BYLAWS AND BOARD POLICIES. ANY CHANGES TO THE BENEFIT PACKAGE MUST BE APPROVED BY THE MMC BOARD OF DIRECTORS. THE BOARD APPROVES ALL COMPENSATION CHANGES FOR THE PRESIDENT AS OUTLINED IN CORPORATE BYLAWS AND BOARD POLICIES. CHANGES IN COMPENSATION FOR THE VICE-PRESIDENTS ARE DETERMINED BY THE PRESIDENT USING RANGES ESTABLISHED AND APPROVED BY THE BOARD. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE FORMS ARE AVAILABLE UPON REQUEST FROM ADMINISTRATION. | FORM 990, PART VI, SECTION C, LINE 18 | |
| THE FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FROM ADMINISTRATION. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED LOSSES ON INVESTMENTS: -388,044. | FORM 990, PART XI, LINE 5: |
| THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. | FORM 990, PART XI, LINE 2C |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 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 | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MEDICAL SERVICES INC | |||||||||||
| 11040 N STATE ROAD 77 | HAYWARD | WI | 54843 | 391536207 | HEALTH CARE | WI | 501(C)(3) | 170(B)(1)(A)(III) | REGIONAL ENTERPRISES INC | 1 | |
| REGIONAL ENTERPRISES INC | |||||||||||
| 1615 MAPLE LANE | ASHLAND | WI | 54806 | 391555837 | SUPPORT | WI | 501(C)(3) | 509(A)(3) | 0 | N/A | |
| REI MEDICAL CLINICS INC | |||||||||||
| 1615 MAPLE LANE | ASHLAND | WI | 54806 | 391701306 | SUPPORT | WI | 501(C)(3) | 509(A)(3) | REGIONAL ENTERPRISES INC | 1 | |
| TAMARACK PROFESSIONAL GROUP INC | |||||||||||
| 1615 MAPLE LANE | ASHLAND | WI | 54806 | 391198085 | HEALTH CARE | WI | 501(C)(3) | 509(A)(3) | REGIONAL ENTERPRISES INC | 1 | |
| MMC DEVELOPMENT CORP INC | |||||||||||
| 1615 MAPLE LANE | ASHLAND | WI | 54806 | 391360035 | SUPPORT | WI | 501(C)(3) | 170(B)(1)(A)(VI) | 0 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| REGIONAL ENTERPRISES INC | ||
| L | 1854592 | VALUE OF SERVICES |
| TAMARACK PROFESSIONAL GROUP | ||
| L | 1647136 | VALUE OF SERVICES |
| MEDICAL SERVICES | ||
| K | 345499 | VALUE OF SERVICES |
| REGIONAL ENTERPRISES INC | ||
| Q | 326058 | CASH |
Comments