COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC (EIN 39-0987025)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-09
- IRS object ID
- 201211309349301341
- Schema version
- 2010v3.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-09T12:14:06-07:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | 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 | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390987025 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Community Memorial Hospital of Menomonee | BusinessNameLine1 |
| Business Name Line2 | Falls Inc | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COMM | NameControl |
| Phone | 4147770960 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | W180 N8085 Town Hall Road | AddressLine1 |
| City | Menomonee Falls | City |
| State | WI | State |
| ZIP Code | 53051 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jeffrey Van De Kreeke | Name |
| Title | Sr VP Finance & CFO | Title |
| Date Signed | 2012-05-09 | DateSigned |
| 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 | Petasnick William D | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | W180 N8085 Town Hall Road | AddressLine1 |
| City | Menomonee Falls | City |
| State | WI | State |
| ZIP Code | 53051 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 312995448 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.communitymemorial.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1959 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | To improve quality of life and meet the comprehensive needs of the community by providing high-quality, safe, cost-effective health services while serving our patients with compassionate, dignified and state-of-the art care. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1554 | TotalNbrEmployees |
| Total Nbr Volunteers | 206 | TotalNbrVolunteers |
| Total Gross UBI | 157618 | TotalGrossUBI |
| Contributions Grants Current Year | 114 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 175412913 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 178537645 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 5461085 | InvestmentIncomePriorYear |
| Investment Income Current Year | 9028823 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2891106 | OtherRevenuePriorYear |
| Other Revenue Current Year | 9591746 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 183765104 | TotalRevenuePriorYear |
| Total Revenue Current Year | 197158328 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 50000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 47500 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 64859051 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 68218146 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 232396 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 110210162 | OtherExpensePriorYear |
| Other Expenses Current Year | 122229121 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 175119213 | TotalExpensesPriorYear |
| Total Expenses Current Year | 190494767 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 8645891 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 6663561 | RevenuesLessExpensesCY |
| Total Assets BOY | 305532900 | TotalAssetsBOY |
| Total Assets EOY | 307452791 | TotalAssetsEOY |
| Total Liabilities BOY | 178937983 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 161666607 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 126594917 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 145786184 | NetAssetsOrFundBalancesEOY |
| Mission Description | To improve quality of life and meet the comprehensive needs of the community by providing high-quality, safe, cost-effective health services. Our exceptional employees, volunteers and dedicated medical staff work collaboratively to serve our patients with compassionate, dignified and state-of-the art care. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 96626143 | Expense |
| Revenue | 112194355 | Revenue |
| Description | Inpatient Services:Community Memorial Hospital was founded in 1964 by citizens of the community it serves and specializes in cardiovascular services, women's health, cancer care, and advanced surgical procedures. Combining next-generation technology with personalized care, Community Memorial strives to enhance and improve the quality of life in Waukesha, Washington, Milwaukee and Ozaukee counties.Community Memorial Hospital is approved for 237 beds of which 202 are staffed - and had 9,449 patient admissions and 43,164 patient days related to a wide range of inpatient services, including internal medicine, psychiatry, cardiology, general surgery, orthopedics, rehabilitation services, obstetrics and maternity care, pulmonary medicine, and other specialty care for the twelve months ended June 30, 2011.Community Memorial's heart surgery program is the third largest in southeastern Wisconsin. The Heart and Vascular Center is staffed with experienced cardiac professionals utilizing the state-of-the-art technology to treat patients. In 2008, surgeons began using the da Vinci Robotic Surgery system to perform minimally invasive procedures. The growing demand for robotic-assisted laparoscopic surgery has been driven by improved outcomes such as less pain, shorter recovery time and fewer complications. During fiscal year 2011, Community Memorial had 15,093 cardiac procedures.In 2008, the Cancer Care Center at Community Memorial received the prestigious American College of Surgeons Commission on Cancer Outstanding Achievement Award, affirming its commitment to high-quality cancer care. The award recognizes cancer programs that provide the highest quality care to cancer patients and is received by only 66 programs in the US annually. During fiscal year 2011, Community Memorial had 554 cancer registry cases.The Birthing Center at Community Memorial includes 13 specialty equipped rooms and provides the full spectrum of prenatal services for both normal and high-risk pregnancies. Staffing is provided by leading obstetricians and board-certified neonatologists from the Medical College of Wisconsin. During fiscal year 2011, Community Memorial had 987 births.In addition to the cardiac, cancer care and birthing services noted above, the Hospital provided a variety of inpatient ancillary treatments and procedures during the fiscal year including but not limited to the following: - Surgeries: 3,648 - Laboratory Tests: 426,453 - CT Scans: 4,623 - Medical Imaging Exams: 16,615 - MRI's: 902 - Nuclear Medicine Scans: 328 - Ultrasounds: 3,012 | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 52792830 | Expense |
| Revenue | 61298706 | Revenue |
| Description | Outpatient Services:Community Memorial had 92,249 outpatient visits in the twelve months ended June 30, 2011. Community offers a wide variety of ancillary, specialty and subspecialty services including but not limited to the following: - Allergy/Immunology - Cardiology - Clinical Genetics - Dermatology - Electrophysiology - Endocrinology - Family Practice - Gastroenterology - Gerontology - Gynecologic Oncology - Gynecology - Hand Surgery - Hematology - Infectious Disease - Internal Medicine - Interventional Radiology - Magnetic Resonance Imaging - Neonatology - Nephrology - Neurosurgery - Nuclear Medicine - Occupational Medicine - Oncology - Ophthalmology - Oral Surgery - Otolaryngology - Pathology - Pediatrics - Pedodontics - Perinatology - Periodontics - Physical Medicine and Rehabilitation - Plastic/Reconstructive Surgery - Podiatry - Psychiatry - Psychology - Pulmonary Medicine - Radiology - Radiation Oncology - Rheumatology - Thoracic Surgery - Urology - Vascular Surgery - Thoracic Surgery | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4344591 | Expense |
| Revenue | 5044583 | Revenue |
| Description | Emergency Services:Community Memorial's Emergency Department is a Level III Trauma Center and provides around-the-clock emergency care for adults and children throughout northern Waukesha, Milwaukee, and Washington counties. During fiscal year 2011, the emergency department had 20,167 emergency visits, with patients receiving expert care from board-certified emergency physicians and specialists in trauma, neurosurgery, cardiology, orthopedics and others. Community Memorial is accredited by the Joint Commission as a certified advanced Primary Stroke Center, demonstrating its ability to provide care from a multi-disciplinary team of neurologists, neurosurgeons, emergency department specialists, radiologists, pharmacists, technicians and more all working in a coordinated, collaborative system. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 153763564 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | true | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | true | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 271 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1554 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | false | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | true | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | David Dirksmeyer | NamePerson |
| Telephone Number | 4147770960 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N74W127501 Leatherwood Ct | AddressLine1 |
| City | Menomonee Falls | City |
| State | WI | State |
| ZIP Code | 53051 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (24 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | FormerFormer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Zorbini John | ||||||||
| Sr VP HR Froedtert Health | 0.00 | X | 0 | 325769 | 34625 | |||
| White MD Michael G | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Turtenwald Robyn | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Templin Susan | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Stadelmann Douglas J | ||||||||
| Dir & Secretary | 1.00 | 0 | 0 | 0 | X | X | ||
| Specht-Palmert Christine | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Shepherd MD Dennis W | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Sanders Paul A | ||||||||
| Sr VP, Clncl Srvcs | 50.00 | 321330 | 0 | 38353 | X | |||
| Pollard Dennis | ||||||||
| Dir & President | 45.00 | 0 | 476288 | 42573 | X | X | ||
| Pieters Robert B | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Petasnick William D | ||||||||
| Director | 1.00 | 0 | 1302731 | 726685 | X | |||
| O'Connell Blaine J | ||||||||
| FH CFO | 1.00 | 0 | 598091 | 32708 | X | |||
| Lux Teresa M | ||||||||
| Director | 50.00 | 219722 | 0 | 25148 | X | |||
| Jacobson Catherine A | ||||||||
| FH CFO | 1.00 | 0 | 426832 | 5511 | X | |||
| Hart Daniel | ||||||||
| Dir & Treasurer | 1.00 | 0 | 0 | 0 | X | X | ||
| Hackett MD James G | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Goldberg MD David F | ||||||||
| Director | 50.00 | 227769 | 0 | 32202 | X | |||
| Freiberg Kerry J | ||||||||
| VP Extrnl Affairs | 50.00 | 214276 | 0 | 33200 | X | |||
| Evenson Rock E | ||||||||
| VP Pln & Prg Dvlp | 50.00 | 257460 | 0 | 38619 | X | |||
| Ellis Sharon Q | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Debra McClure | ||||||||
| Nurse Anesthetist | 50.00 | 273650 | 0 | 17231 | X | |||
| Bestor William E | ||||||||
| Former Pres/CEO | 0.00 | 331897 | 0 | 0 | X | |||
| Becker Richard C | ||||||||
| Dir & Chair | 1.00 | 0 | 0 | 0 | X | X | ||
| Bast Ronald R | ||||||||
| Dir & Vice Chr | 1.00 | 0 | 0 | 0 | X | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1846104 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3129711 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1026855 | TotalOtherCompensation |
| Number Individuals GT100 K | 51 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Von Briesen & Roper | |||||
| 411 E Wisconsin Ave Ste 700 | Milwaukee | WI | 53201 | Legal | 563505 |
| Pyramid Healthcare Solutions | |||||
| PO Box 17389 | Clearwater | FL | 33762 | HIM Outsourcing | 632546 |
| Medical College of WI | |||||
| 8701 Watertown Plank Rd | Milwaukee | WI | 53206 | Physicians | 2109229 |
| Critical Care Solutions | |||||
| N74W12501 Leatherwood Ct | Menomonee Falls | WI | 53051 | Virtual ICU | 543749 |
| Columbia St Marys | |||||
| 4425 N Port Washington Rd | Glendale | WI | 53212 | Physicians | 3003989 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 16 | NumberOfContractorsGT100K |
| Fundraising Events | 114 | FundraisingEvents |
| Total Contributions | 114 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Outpatient Revenue | 900099 | 61298706 | 61298706 |
| Inpatient Revenue | 900099 | 112194355 | 112194355 |
| Emergency/Trauma Revenue | 900099 | 5044584 | 5044584 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 178537645 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4907585 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1554499 | RelatedOrExemptFunctionIncome |
| Exclusion | $3,353,086 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5221 | TotalRevenueColumn |
| Exclusion | $5,221 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1002484 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 466390 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 536094 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 536094 | TotalRevenueColumn |
| Unrelated Business Revenue | 76608 | UnrelatedBusinessRevenue |
| Exclusion | $459,486 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 115743784 | Securities |
| Other | 3704889 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 112535123 | Securities |
| Other | 2797533 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3208661 | Securities |
| Other | 907356 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4116017 | TotalRevenueColumn |
| Exclusion | $4,116,017 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 79260 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 114 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 38074 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 41186 | TotalRevenueColumn |
| Exclusion | $41,186 | ExclusionAmount |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Other Dept Operating Rev | 561499 | 1612384 | 1531374 | 81010 | |
| Dietary Revenue | 561499 | 657699 | $657,699 | ||
| Corporate Allocated Rev | 561000 | 6505710 | 6505710 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 238673 | TotalRevenueColumn |
| Exclusion | $238,673 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 9014466 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 197158328 | TotalRevenueColumn |
| Related Or Exempt Function Income | 188129228 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 157618 | UnrelatedBusinessRevenue |
| Exclusion | $8,871,368 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47500 | Total |
| Program Services | 47500 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 573076 | Total |
| Management And General | 573076 | 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 | 62736084 | Total |
| Program Services | 57850946 | ProgramServices |
| Management And General | 4740110 | ManagementAndGeneral |
| Fundraising | 145028 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 473041 | Total |
| Program Services | 432738 | ProgramServices |
| Management And General | 39215 | ManagementAndGeneral |
| Fundraising | 1088 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4435945 | Total |
| Program Services | 4058002 | ProgramServices |
| Management And General | 367740 | ManagementAndGeneral |
| Fundraising | 10203 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 282000 | Total |
| Program Services | 282000 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 878067 | Total |
| Program Services | 601235 | ProgramServices |
| Management And General | 276832 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12881102 | Total |
| Program Services | 11704223 | ProgramServices |
| Management And General | 1176879 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 133312 | Total |
| Program Services | 7372 | ProgramServices |
| Management And General | 125940 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36044982 | Total |
| Program Services | 35575911 | ProgramServices |
| Management And General | 461501 | ManagementAndGeneral |
| Fundraising | 7570 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 497886 | Total |
| Program Services | 141674 | ProgramServices |
| Management And General | 356212 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4418475 | Total |
| Program Services | 3603708 | ProgramServices |
| Management And General | 803279 | ManagementAndGeneral |
| Fundraising | 11488 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 65691 | Total |
| Program Services | 30305 | ProgramServices |
| Management And General | 34489 | ManagementAndGeneral |
| Fundraising | 897 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 116108 | Total |
| Program Services | 97359 | ProgramServices |
| Management And General | 18629 | ManagementAndGeneral |
| Fundraising | 120 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2211530 | Total |
| Program Services | 1803724 | ProgramServices |
| Management And General | 402056 | ManagementAndGeneral |
| Fundraising | 5750 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7362794 | Total |
| Program Services | 6005095 | ProgramServices |
| Management And General | 1338556 | ManagementAndGeneral |
| Fundraising | 19143 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8522 | Total |
| Program Services | 8522 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| State Hospital Assessment | 5472253 | 5472253 | ||
| Provision for Uncollectable | 4810000 | 4810000 | ||
| Dues & Subscriptions | 308295 | 107308 | 200238 | 749 |
| Corporate Allocations | 40780214 | 15189030 | 25560824 | 30360 |
| Clinic Practice Fee | 5898963 | 5898963 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58927 | Total |
| Program Services | 35696 | ProgramServices |
| Management And General | 23231 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 190494767 | Total |
| Program Services | 153763564 | ProgramServices |
| Management And General | 36498807 | ManagementAndGeneral |
| Fundraising | 232396 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 539468 | BOY |
| EOY | 7300 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7199533 | BOY |
| EOY | 10956674 | 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 | 20690343 | BOY |
| EOY | 27698357 | 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 | 1675089 | BOY |
| EOY | 56000 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3726241 | BOY |
| EOY | 3880289 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3131291 | BOY |
| EOY | 2556770 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 164657016 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 85345915 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85642186 | BOY |
| EOY | 79311101 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 134375008 | BOY |
| EOY | 127517832 | 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 | 48553741 | BOY |
| EOY | 55468468 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 305532900 | BOY |
| EOY | 307452791 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12113961 | BOY |
| EOY | 13245503 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6955 | BOY |
| EOY | 6648 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 69223820 | BOY |
| EOY | 66424522 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 549764 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97043483 | BOY |
| EOY | 81989934 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 178937983 | BOY |
| EOY | 161666607 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 125905277 | BOY |
| EOY | 144898831 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 689640 | BOY |
| EOY | 887353 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 126594917 | BOY |
| EOY | 145786184 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 305532900 | BOY |
| EOY | 307452791 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 6663561 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 12527706 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4094065 | BeginningOfYearBalance |
| Contributions | 1398548 | Contributions |
| Investment Earnings Or Losses | 623704 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 374633 | GrantsOrScholarships |
| Other Expenditures | 1066388 | OtherExpenditures |
| Administrative Expenses | 340 | AdministrativeExpenses |
| End Of Year Balance | 4674956 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3166213 | BeginningOfYearBalance |
| Contributions | 904863 | Contributions |
| Investment Earnings Or Losses | 384524 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 304571 | GrantsOrScholarships |
| Other Expenditures | 56965 | OtherExpenditures |
| Administrative Expenses | -1 | AdministrativeExpenses |
| End Of Year Balance | 4094065 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3670185 | BeginningOfYearBalance |
| Contributions | 484004 | Contributions |
| Investment Earnings Or Losses | -466270 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 353150 | GrantsOrScholarships |
| Other Expenditures | 168686 | OtherExpenditures |
| Administrative Expenses | -130 | AdministrativeExpenses |
| End Of Year Balance | 3166213 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 1.00000 | BoardDesignatedEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | true | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | true | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 724692 | OtherCostOrOtherBasis |
| Book Value | 724692 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 95689233 | OtherCostOrOtherBasis |
| Depreciation | 35793919 | Depreciation |
| Book Value | 59895314 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2096307 | OtherCostOrOtherBasis |
| Depreciation | 1715708 | Depreciation |
| Book Value | 380599 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 33151773 | OtherCostOrOtherBasis |
| Depreciation | 26607724 | Depreciation |
| Book Value | 6544049 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 32995011 | OtherCostOrOtherBasis |
| Depreciation | 21228564 | Depreciation |
| Book Value | 11766447 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 79311101 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (7 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Senior Management Deferred Compensation | 71048 |
| Rounding | 1 |
| FH Executive Reitirement 457f | 131947 |
| Executive Deferred Compensation | 2168463 |
| Due from Employee | 36 |
| Due from Affiliates | 924482 |
| Collateral held for securties loaned | 40906676 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 55468468 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Pension Liability | $24,121,954 |
| Payable under securties lending agreemen | $41,165,484 |
| Market Adjustment - Swaps | $3,249,632 |
| Due to Affiliates | $13,452,864 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 81989934 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part X | Part X : FIN48 Footnote | Froedtert Health applies ASC No. 740, Income Taxes (formerly FIN 48), which clarifies the accounting for uncertainty in income taxes recognized in a company's financial statements. ASC No. 740 prescribes a more-likely than-not recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken. Under ASC No. 740, tax positions are evaluated for recognition, derecognition, and measurement using consistent criteria and provide more information about the uncertainty in income tax assets and liabilities. As of June 30, 2011 and 2010, FH does not have an asset or liability recorded for unrecognized tax benefits. |
| Part XI, Line 8 | Part XI, Line 8: Other Changes in Net Assets or Fund Balances | Pension Adjustment $7174999 Change in Foundation Restricted Net Assets $197713 Transfers to Affiliates $ -2503709 Capital Contributions $ -1113204 Change in Foundation Unrestricted Net Assets $ -1045499 Other $ -10417 |
| Part V, Line 4 | Part V, Line 4: Intended uses of the endowment fund. | The funds are held by Community Memorial Foundation of Menomonee Falls (CMF), a related organization. The board designated endowment was created to support long range financial needs of Community Memorial Hospital of Menomonee Falls, Inc and its affiliates. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agreement Ref Fundraising | false | AgreementRefFundraising |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Cheery Cherry Fall Fair | NameOfEvent1 |
| Gross Receipts Event1 | 57869 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 57869 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 5803 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 4120 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 9902 | OtherDirectExpensesEvent1 |
| Name Of Event2 | Special Event Projects | NameOfEvent2 |
| Gross Receipts Event2 | 10550 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 10550 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 8318 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 1 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 7673 | GrossReceiptsOtherEvents |
| Gross Revenue Other Events | 7673 | GrossRevenueOtherEvents |
| Other Direct Expenses Other Events | 6021 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 76092 | GrossReceiptsTotal |
| Gross Revenue Total Events | 76092 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 5803 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 4120 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 24241 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 34164 | DirectExpenseSummaryEvents |
| Net Income Summary | 41928 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | 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 | 1184023 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1184023 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00620 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9304283 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6790203 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2514080 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01320 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10488306 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6790203 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3698103 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01940 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 56 | NumberOfActivitiesOrPrograms |
| Persons Served | 14065 | PersonsServed |
| Total Community Benefit Expense | 2171295 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 42650 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2128645 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01120 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Persons Served | 693 | PersonsServed |
| Total Community Benefit Expense | 917077 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 915077 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00480 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 19 | NumberOfActivitiesOrPrograms |
| Persons Served | 3550 | PersonsServed |
| Total Community Benefit Expense | 325124 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 23715 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 301409 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00160 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 81 | NumberOfActivitiesOrPrograms |
| Persons Served | 18308 | PersonsServed |
| Total Community Benefit Expense | 3413496 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 68365 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3345131 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01760 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 81 | NumberOfActivitiesOrPrograms |
| Persons Served | 18308 | PersonsServed |
| Total Community Benefit Expense | 13901802 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6858568 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7043234 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03700 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 2847 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2847 | NetCommunityBuildingExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 13526 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 13526 | 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 | 32035 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 32035 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 2688 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2688 | NetCommunityBuildingExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 83639 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 83639 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 134735 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 134735 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $2,283,044 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 46789974 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 58562176 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -11772202 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 0 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Community Memorial Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | W180 N8085 Town Hall Road | AddressLine1 |
| City | Menomonee Falls | City |
| State | WI | State |
| ZIP Code | 53051 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Community Memorial Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 10 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | true | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| 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 |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | true | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| 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 |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | true | AmountsGenerallyBilled |
| Gross Charges | true | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part V - Explanation of Number of Facility Type | Community Memorial Hospital is the only facility listed under this reporting of the IRS Form 990, Schedule H. | |
| Part VI - States Where Community Benefit Report Filed | WI | |
| Part VI - Affilated Health Care System Roles and Promotion | Every year, the Froedtert Health partners engage in a variety of outreach activities in collaboration with key leaders and organizations in their communities that help improve health and quality of life. Much more than the provision of charity care, the American Hospital Association defines community benefit as "promoting and protecting the health and well being of the entire community through responsive programs and services." Froedtert Health strategies are based on the unique needs of each of the communities that we serve. By conducting regular community needs assessments that monitor critical public health issues, and actively seeking community input, the FH partners have built important relationships with their local communities, and are committed to providing meaningful outreach programs that link each hospital to their neighbors and patients.In 2011 FY, 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 $40.7 million in uncompensated services. Beyond providing care for the poor, we contributed $58.6 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, and are held accountable for achieving, community benefit goals and strategies are 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 member partners have built important local relationships and are committed to providing 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 | The Community Outreach Steering Committee (COSC) actualizes the mission of Community Memorial Hospital (CMH) through community benefit activities that improve the quality of life and enhance wellness resources which meet identified comprehensive health needs of the communities served. The Community Outreach Steering Committee is appointed annually by the hospital president and is advisory to the CMH Board and Administration. Membership appointments are made each June with members serving one year terms. The COSC meets quarterly and is composed of hospital and board representatives plus community members representing the various constituencies of the total service area. Functions include:-Provide a leadership role in advocating community wide responses to health care needs in the community.-Facilitate and support community and health care partnerships.-Envision, assess and guide new community benefit opportunities.-Identify and describe unmet health needs.-Promote universal access to health care.-Determine allocation of the Community Outreach Services Fund.-Annually submit a community benefit report, which describes the scope of community benefit provided directly and in collaboration with others. | |
| Part VI - Community Building Activities | To promote the health of our communities, Community Memorial Hospital participates in community building activities which are not included elsewhere on Schedule H. These activities include:1. Economic Development: participation in local chamber of commerce boards focused on economic development.2. Community Support: participation in local emergency preparedness and youth focused coalitions. 3. Coalition Building: participation in local community groups and coordination of fundraising for the local United Ways.4. Community Health Improvement Advocacy: participation in creating the community health improvement plan with the local health department.5. Workforce Development: diversity training that recruits health professionals in our traditionally underserved community. | |
| Part VI - Community Information | Since its founding in 1964 by the citizens of the community it serves, Community Memorial Hospital (CMH) has focused on the emerging healthcare and wellness needs of over 400,000 people in the four county region of Waukesha, Washington, northwest Milwaukee, and Ozaukee Counties. Based on the US Census data, the population served by CMH is 77% Caucasian, 16% African American, 3% Asian, and 4% other races. 45% of households have a household income less then $50,000. 7% of the population does not have a high school diploma with 28% whose highest education level is a high school diploma. 34% of the population has a Bachelor's Degree or higher education. The most common occupations for our population is 19% manufacturing, 15% sales/office and 13% health care. Today, CMH ranks as one of the top hospitals nationally based on surveys by the Joint Commission on Accreditation of Healthcare Organizations, which reviews all hospitals for safety and quality healthcare practices. The Hospital has 202 staffed beds and a medical staff of 657 physicians in 49 specialties, over 1,400 employees and 320 volunteers caring for 9,845 inpatients, 87,249 outpatients and 19,596 emergency visits in fiscal 2010. Based on demographic and community needs assessments, CMH has led area community based hospitals by establishing programs in hospital based day surgery, cardiac rehabilitation, and the "Right from the Start" birthing program which matches a personal obstetrics case manager with first time expectant mothers. CMH is accredited by Joint Commission, the Commission on Accreditation of Rehabilitation Facilities (CARF), the American Association of Cardiovascular & Pulmonary Rehabilitation, the American College of Radiology (ACR), the Intersocietal Commission for Accreditation of Echocardiography, the College of American Pathologists (CAP), the American College of Surgeons (ACS), and is licensed by the State of Wisconsin. And, eight area institutions of higher learning send students to CMH for clinical experiences in health care. CMH is more than a healthcare facility; it is a true community partner, joining forces with other organizations who share our vision and values. Our collaborative initiatives include outreach to youth, elderly and the underserved; satellite rehabilitation clinics offering outpatient therapy; community education in parenting and wellness topics; health screenings and support groups; a program for lab house calls to the homebound; and serving as the medical control center for five area Emergency Medical Service units. In July 2009, the American Diabetes Association acknowledged Community Memorial as having a Recognized Diabetes Self Management Education Program for outpatients. In January 2010, Community Memorial received the Gold Recognition as a Wellness Council of America Well Workplace organization, an award that recognizes quality and excellence in worksite health promotion. Also in 2010, the Cancer Care Center received Accreditation with Commendation from the American College of Surgeons - Commission on Cancer. Community Memorial was also recognized as a Quality Respiratory Care Recognition Hospital in 2010. Only 700 hospitals in the U.S. have been named a QRCR institution. The hospital received certification as a Level III Trauma Center in January 2010 and was awarded certification for its Stroke program from the Joint Commission in February 2010. | |
| Part VI - Patient Education of Eligibility for Assistance | Community Memorial Hospital (CMH) has a Financial Counselor who performs outreach to all self pay patients. Contact may be in person or via phone call to patient. The patient is screened for eligibility for state/local programs and/or CMH's Financial Assistance program. Information regarding our financial assistance program is also available in our registration areas, in our ED, and is noted on our billing statements. In addition, during our billing call cycle, if a patient indicates they are unable to pay, they are screened for eligibility for Financial Assistance. | |
| Part VI - Needs Assessment | In the February, 2011 a community health needs assessment was conducted for Froedtert Health Community Memorial Hospital (Menomonee Falls, WI) and Froedtert Health St. Joseph's Hospital (West Bend, WI) by Community Outreach/Public Relations Department staff along with members from the CMH Community Outreach Steering Committee. The community needs assessment team consisted of the following individuals: Andy Dresang, Dianna Forrester, Kerry Freiberg, Jeff Hevey, Amy Maurer, Deb McCann, Geoff Mertens, Mandie Reedy, Timothy Smykal, Sally Slusser, Lisa Susen-Sullivan and John Wandschneider.The community health needs assessment findings are a compilation of state, county and community health assessments along with interviews from 35 different community informants ranging from school district representatives, public health officials, non-profit health and human service professionals, churches, police/fire departments, free clinics and business professionals throughout Waukesha and Washington Counties. This needs assessment is based upon available statistical data as well as anecdotal information from knowledgeable community informants. Since the assessment was prepared for guiding the CMH community outreach programs, the investigation focused on assessing the needs and service gaps as it pertains to the general population and the disadvantaged populations, i.e., people with disproportionate unmet health needs in the hospital's primary service area. The findings of the Assessment were summarized with the top four strategic priorities being identified as Access to Primary and Specialty Care, Chronic Disease Management, Prevention and Wellness and Mental Health. The Community Outreach Steering Committee re-affirmed the findings and through an interactive process establishing the strategic vision, goals and community outreach priorities for Fiscal Year 2012 through 2015. | |
| Part V, Line 21 - Charge Patients Amount Equal Gross Charge for Services | Patients who do not qualify for a self pay discount according to the policy. | Number of Hospital Faciltiy - 0 |
| Part V, Line 20 - Explanation of Eligible Assistance Patients Billed More Than Insurance Rates | Patient who may qualify for a financial assistance discount, but refuse to comply with the policy are not given a discount. | Number of Hospital Faciltiy - 0 |
| Part V, Line 19d - Other Billing Determination of Individuals Without Insurance | According to our self-pay discount policy. | Number of Hospital Faciltiy - 0 |
| Part V, Line 11h - Other Factors Used in Determing Amounts Charged Patients | Out of Pocket Maximum Discount | Number of Hospital Faciltiy - 0 |
| Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment | In the February, 2011 a community health needs assessment was conducted for Froedtert Health Community Memorial Hospital (Menomonee Falls, WI) and Froedtert Health St. Joseph's Hospital (West Bend, WI) by Community Outreach/Public Relations Department staff along with members from the CMH Community Outreach Steering Committee. | Number of Hospital Faciltiy - 0 |
| Part V, Line 3 - Account Input from Person Who Represent the Community | The community health needs assessment findings are a compilation of state, county and community health assessments along with interviews from 35 different community informants ranging from school district representatives, public health officials, non-profit health and human service professionals, churches, police/fire departments, free clinics and business professionals throughout Waukesha and Washington Counties. This needs assessment is based upon available statistical data as well as anecdotal information from knowledgeable community informants. Since the assessment was prepared for guiding the CMH community outreach programs, the investigation focused on assessing the needs and service gaps as it pertains to the general population and the disadvantaged populations, i.e., people with disproportionate unmet health needs in the hospital's primary service area. The findings of the Assessment were summarized with the top four strategic priorities being identified as Access to Primary and Specialty Care, Chronic Disease Management, Prevention and Wellness and Mental Health. The Community Outreach Steering Committee re-affirmed the findings and through an interactive process establishing the strategic vision, goals and community outreach priorities for Fiscal Year 2012 through 2015. | Number of Hospital Faciltiy - 0 |
| Part III, Line 9b - Provisions On Collection Practices For Qualified Patients | Collection policies are the same for all patients. Patients are screened for eligibility for financial assistance before collection procedures begin. If at any point in the collection process, documentation is received that indicates the patient is potentially eligible for financial assistance but has not applied for it; the account is referred back for a financial assistance review. | |
| Part III, Line 8 - Explanation Of Shortfall As Community Benefit | Community Memorial Hospital believes that all of the $11,772,202 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 | Line 1 - Community Memorial Hospital reports accounts receivable for services rendered at net realizable amounts from third-party payers, patients, and others. Community Memorial Hospital provides an allowance for uncollectible accounts based upon a review of outstanding receivables, historical collection information, and existing economic conditions and trends.Line 2 - 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. Line 3 - 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 - Explanation of Costing Methodology | Charity Care and certain other community benefits costs were determined by using internal information to reduce the various activities to cost. We try to present cost information consistently in the different venues that it appears. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Purpose Of GrantPurposeOfGrant | EIN Of RecipientEINOfRecipient |
|---|---|---|---|---|---|---|---|---|
| Other Grants 5000 | ||||||||
| 9200 W Wisconsin Avenue | Milwaukee | WI | 53226 | 501(c)(3) | 20500 | 0 | Various | |
| Community Outreach Health Clinic | ||||||||
| W180 N8085 Town Hall Road | Menomonee Falls | WI | 53051 | 501(c)(3) | 27000 | 0 | Support operations of clinic | 391743056 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 10 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Grantmaker's Description of How Grants are Used | Identifier |
| Explanation | Organizations submit grant requests to the Community Outreach Steering Committee (the Committee). On a quarterly basis the fund allocations are determined. Each organization selected for funds receives an award letter detailing the expectations and conditions of the grant money. In order to comply with applicable tax laws, regulations and the Community Outreach Services Fund policy, the Community Outreach Services Fund will provide grant support to organizations with the understanding that:1) Grant funds distributed will be used only for the purposes designated in the award letter.2) No funds will be used for any political campaign or to support attempts to influence legislation of any governmental body. 3) If the organization loses exempt status, any unexpended funds will be returned to the Community Outreach Steering Committee.4) Adequate accounting records of the expenditures of funds will be maintained by your organization.5) This is a one time grant distribution. Future funding requests will be considered on a case by case basis. In addition, the Committee includes a "Final Report Form" with each organization's award letter. The form requires the organization to provide a brief description of the activity and measurable outcomes/benefits, an expenditure report, and future plans. The Committee requests that each organization submit the "Final Report Form" to the Committee within thirty days after the completion of the project for which the funds were intended or within a maximum of one year from the receipt of funds. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | false | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Zorbini John | |||||||||||
| 239090 | 69704 | 16975 | 16114 | 18511 | 360394 | ||||||
| Sanders Paul A | |||||||||||
| 255890 | 48347 | 17093 | 15503 | 22850 | 359683 | ||||||
| Pollard Dennis | |||||||||||
| 333730 | 128486 | 14072 | 12880 | 29693 | 518861 | ||||||
| Petasnick William D | |||||||||||
| 948461 | 334370 | 19900 | 675099 | 51586 | 2029416 | ||||||
| O'Connell Blaine J | |||||||||||
| 454374 | 125145 | 18572 | 15925 | 16783 | 630799 | ||||||
| Lux Teresa M | |||||||||||
| 161122 | 45700 | 12900 | 10753 | 14395 | 244870 | ||||||
| Jacobson Catherine A | |||||||||||
| 218832 | 208000 | 5511 | 432343 | ||||||||
| Goldberg MD David F | |||||||||||
| 222769 | 5000 | 12720 | 19482 | 259971 | |||||||
| Freiberg Kerry J | |||||||||||
| 137149 | 40754 | 36373 | 13675 | 19525 | 247476 | ||||||
| Evenson Rock E | |||||||||||
| 151619 | 36009 | 69832 | 15572 | 23047 | 296079 | ||||||
| Debra McClure | |||||||||||
| 273068 | 582 | 6971 | 10260 | 290881 | |||||||
| Bestor William E | |||||||||||
| 331897 | 331897 | ||||||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Sch J, Part I, Line 7 | Part I, Line 7: Non-Fixed payments not listed above | Certain management employees participate in an incentive compensation plan that includes some non-fixed elements. Upon the attainment of a certain financial threshold, incentive compensation is available for meeting identified goals in the areas of financial performance, operational efficiencies, quality improvements, customer satisfaction, strategic growth and partnership initiatives. In some cases the determination of whether a goal is met is absolute while others require a certain amount of discretion to determine if goal is met. In addition, the incentive compensation includes a purely discretionary component. |
| Sch J, Part I, Line 1b | Part I, Line 1b: Reason for not following policy regarding payment provisions for expenses | Health club membership subsidy/discount is a benefits program applicable to all employees and is documented in the benefit program documents. Dining club membership is specified in the written employment contract which was approved by the Compensation Committee. |
| Sch J, Part I, Line 1a | Part I, Line 1a: Relevant information in regards to selections on 1a. | Discounted or subsidized health club membership is available to all employees. Dining Club membership for President used for business purposes. All amounts included in taxable compensation. Applicable severance payments are reflected in Schedule J, Part II. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Riteway Bus Services | |||
| See Sch O | 55852 | Transportation Services | false |
| Carrie Fitzgerald Hart | |||
| See Sch O | 144068 | Employment | false |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Schedule L - Part IV (b) | Carrie Fitzgerald Hart - Husband, Daniel Hart, is a directorRiteway Bus Services - Entity more than 35% owned by Ron Bast, director. | |
| Part VII - Section A 1a, Column B | Approximate hours per week spent working on related entities:Petasnick - 55 hoursPollard - 6 hoursZorbini - 50 hoursFreiberg - 1 hourJacobson - 55 hoursO'Connell - 55 hoursPieters - 1 hourEllis - 1 hourTemplin - 1 hourBecker - 1 hourHart - 1 hourBast - 3 hours | |
| Part VII - Section A 1a Columns C-F | Individuals listed as 'former' but receiving compensation during the year is due to the fact the individual is still employed by the organization, but is no longer in the role of director, officer, key employee, etc. in the current year, but was reported as such on the organization's 990 in the previous five years. | |
| Part IX 24a Corporate Allocations | Froedtert Health allocates its revenues and expenses to Froedtert Memorial Lutheran Hospital, Community Memorial Hospital of Menomonee Falls, St. Joseph's Community Hospital and West Bend Clinic. The allocation is calculated by applying an allocation metric to each accounting unit at Froedtert Health, including a flat percentage, percentage of gross revenue to total, percentage of supply expense to total, etc. Each entity then receives its portion of the Froedtert Health allocation on a monthly basis. | |
| Part IV, Line 24 | Even though the liability is on the books of Community Memorial Hospital of Menemonee Falls, this question was answered no, as Schedule K will be completed on the Form 990 of the parent corporation, Froedtert Health, Inc. | |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Governing Documents, COI Policy and Financial Statements are available to the public through the corporate office upon request. | Form 990, Part VI, Line 19 |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | In establishing the compensation of the organizations CEO/Directors/Top Management, independent compensation consultants are utilized, compensation studies are completed to gather comparative data, and amounts are reviewed and approved by the Compensation Committee of the Board of Directors. | Form 990, Part VI, Line 15b |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | On an annual basis all officers, directors, trustees, key employees are required to complete a conflict of interest disclosure statement. The data is compiled, and the Vice President-Chief Compliance Officer (CCO), the Vice-President-General Counsel and/or delegate will review all forms and notifications to determine if any conflicts of interest exist in the disclosure documents. If it is determined that a conflict of interest exists, then the person making the disclosure shall be relieved of his/her obligations on behalf of a 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 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 7a: How Members or Shareholders Elect Governing Body | Froedtert Health, Inc., as the member of Community Memorial Hospital of Menomonee Falls, has the final approval of election of all board members. | Form 990, Part VI, Line 7a |
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | Froedtert Health, Inc. is the member of Community Memorial Hospital of Menomonee Falls. | Form 990, Part VI, Line 6 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Total IncomeTotalIncome |
|---|---|---|---|---|---|---|---|---|
| West Bend Surgery Center LLC | ||||||||
| 1710 Vogt Drive | West Bend | WI | 53095 | 391954169 | Surgical Services | WI | West Bend Clinic Inc | |
| Horizon Ventures Limited LLC | ||||||||
| W180 N8085 Town Hall Road | Menomonee Falls | WI | 53051 | 391855822 | Lessor of Medical Office Building | WI | NA | 600000 |
Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Froedtert Physician Partners Inc | ||||||||||
| 9200 W Wisconsin Ave | Milwaukee | WI | 53226 | 272042610 | Health Care Services | WI | 501(c)(3) | 3 | Froedtert Health Inc | false |
| QHS 1 Inc | ||||||||||
| N74 W12501 Leatherwood Court | Menomonee Falls | WI | 530514480 | 202636686 | Health Care Services | WI | 501(c)(3) | Ln 11, Type 1 | Froedtert Health Inc | false |
| Froedtert Hospital Foundation Inc | ||||||||||
| 9200 West Wisconsin Avenue | Milwaukee | WI | 532263596 | 391431192 | Health, Welfare, Research and Education Promotion | WI | 501(c)(3) | Ln 11, Type 1 | Froedtert Memorial Lutheran Hospital | false |
| St Josephs Community Foundation Inc | ||||||||||
| 3200 Pleasant Valley Road | West Bend | WI | 530953686 | 392034296 | Health and Welfare Promotion | WI | 510(c)(3) | Ln 11, Type 1 | St Josephs Community Hospital Inc | false |
| West Bend Clinic Inc | ||||||||||
| 1700 W Paradise Drive | West Bend | WI | 53095 | 392034294 | Health Care Services | WI | 501(c)(3) | 3 | Froedtert Health Inc | false |
| St Josephs Community Hospital Inc | ||||||||||
| 3200 Pleasant Valley Road | West Bend | WI | 530953868 | 390806302 | Hospital Care Services | WI | 501(c)(3) | 3 | Froedtert Health Inc | false |
| Froedtert Memorial Lutheran Hospital Inc | ||||||||||
| 9200 West Wisconsin Avenue | Milwuakee | WI | 532263522 | 396105970 | Hospital | WI | 501(c)(3) | 3 | Froedtert Health Inc | false |
| Community Memorial Foundation | ||||||||||
| W180 N8085 Town Hall Road | Menomonee Falls | WI | 53051 | 391635057 | Health and Welfare promotion | WI | 501(c)(3) | Ln 11, Type 1 | Community Memorial Hospital of MF | false |
| Community Outpatient Health Services | ||||||||||
| W180 N8085 Town Hall Road | Menomonee Falls | WI | 53051 | 391743056 | Outpatient Medical and Dental Services | WI | 501(c)(3) | 3 | Community Memorial Hospital of MF | false |
| Froedtert Health Inc | ||||||||||
| 9200 West Wisconsin Avenue | Milwaukee | WI | 532263596 | 392014409 | Management Services | WI | 501(c)(3) | Ln 11, Type 1 | NA | false |
Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|
| FHHP LLC | ||||||||||
| 9200 W Wisconsin Ave | Milwaukee | WI | 53226 | 452221564 | Health Care | WI | na | n/a | false | false |
| Fitness Development Associates LLC | ||||||||||
| 9200 W Wisconsin Avenue | Milwaukee | WI | 53226 | 391936497 | Real Estate | WI | NA | false | false | |
| Milwaukee Center of Diagnostic Imaging | ||||||||||
| 5775 Wayzata Boulevard Suite 400 | St Louis Park | MN | 55416 | 411748361 | Health Care | WI | NA | false | false | |
| FMLH MCW Real Estate Ventures LLC | ||||||||||
| 9200 W Wisconsin Avenue | Milwaukee | WI | 53226 | 260629591 | Real Estate | WI | na | false | false | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|
| Progressive Physician Network Inc | |||||||||
| 9200 W Wisconsin Ave | Milwaukee | WI | 53226 | 270367127 | Management Services | WI | Froedtert Health Inc | C | |
| Kettle Moraine Anesthesiology Inc | |||||||||
| PO Box 8031 | Appleton | WI | 54912 | 141842439 | Health Care | WI | West Bend Clinic Inc | C | |
| Community Ventures of Menomonee Falls | |||||||||
| W180N8085 Town Hall Road | Menomonee Falls | WI | 53051 | 391635059 | Inactive | WI | NA | C | 1.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 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 |