THEDACARE INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- THEDACARE INC (EIN 39-1509362)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-12
- IRS object ID
- 201243179349302139
- Schema version
- 2011v1.2
- 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 B
- Schedule C
- Schedule D
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-12T13:21:35-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420714325 | EIN |
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 | PO BOX 5946 | AddressLine1 |
| City | MADISON | City |
| State | WI | State |
| ZIP Code | 537050946 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391509362 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THEDACARE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | THED | NameControl |
| Phone | 9207355560 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 122 EAST COLLEGE AVENUE | AddressLine1 |
| City | APPLETON | City |
| State | WI | State |
| ZIP Code | 54911 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TIM A OLSON | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 9207355560 | Phone |
| Date Signed | 2012-11-08 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES G GRAHAM | Name |
| PTIN | P00006111 | PTIN |
| Phone | 6088332612 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | TIM A OLSON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 122 EAST COLLEGE AVENUE | AddressLine1 |
| City | APPLETON | City |
| State | WI | State |
| ZIP Code | 54911 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 506887782 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.THEDACARE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1985 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | IMPROVING THE HEALTH OF OUR COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 6579 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 4573312 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -53384 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 530471 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 177349 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 237423136 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 247317178 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 45900 | InvestmentIncomePriorYear |
| Investment Income Current Year | 11302346 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 5190724 | OtherRevenuePriorYear |
| Other Revenue Current Year | 5724376 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 243190231 | TotalRevenuePriorYear |
| Total Revenue Current Year | 264521249 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 2420009 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 722750 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 169126713 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 178893522 | 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 | 84601210 | OtherExpensePriorYear |
| Other Expenses Current Year | 87067913 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 256147932 | TotalExpensesPriorYear |
| Total Expenses Current Year | 266684185 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -12957701 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -2162936 | RevenuesLessExpensesCY |
| Total Assets BOY | 241298868 | TotalAssetsBOY |
| Total Assets EOY | 433132372 | TotalAssetsEOY |
| Total Liabilities BOY | 459587454 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 696190372 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -218288586 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -263058000 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | IMPROVING THE HEALTH OF OUR COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 117233504 | Expense |
| Revenue | 117092143 | Revenue |
| Description | THEDACARE OPERATES 23 MEDICAL CLINICS IN 13 COMMUNITIES THROUGHOUT THE FOX VALLEY AND SURROUNDING AREAS. THE SERVICES INCLUDE FAMILY & GENERAL PRACTICES, INTERNAL MEDICINE, ORTHOPEDICS, ALLERGY/IMMUNOLOGY, AND PEDIATRICS. ALONG WITH ROUTINE PHYSICIAN AND NURSING CARE, SOME LOCATIONS PROVIDE OFFICE HOURS WITH SPECIALTY MEDICAL PROVIDERS. MOST CLINICS ALSO OFFER DIAGNOSTIC SERVICES SUCH AS X-RAY, ULTRASOUND, MRI, CAT SCAN, MAMMOGRAPHY AND MEDICAL LABORATORY TESTING. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 77642411 | Expense |
| Grants | 722750 | Grants |
| Revenue | 74449640 | Revenue |
| Description | THEDACARE PROVIDES OPERATIONAL AND ADMINISTRATIVE SUPPORT SERVICES FOR HOSPITALS, MEDICAL CLINICS AND VARIOUS OTHER HEALTHCARE PROVIDERS. CENTRALIZING THESE SERVICES ALLOWS MEDICAL PROFESSIONALS TO CONCENTRATE ON GIVING THEIR PATIENTS THE BEST POSSIBLE CARE, WHILE ENJOYING THE BENEFITS OF EFFICIENT AND COST-EFFECTIVE BUSINESS MANAGEMENT. THEDACARE'S MAIN OPERATIONAL SERVICES INCLUDE A REFERENCE LABORATORY, TRANSCRIPTION SERVICES, BIOMEDICAL EQUIPMENT MAINTENANCE, PLUS A MEDICAL REFERENCE LIBRARY, STAFF EDUCATION AND PROFESSIONAL DEVELOPMENT PROGRAMS. MANY SENIOR CITIZENS SUBSCRIBE TO "LIFELINE," A MONITORED HELP/ALARM SYSTEM CONNECTED TO THEDACARE'S NURSE-STAFFED 24-HOUR CALL CENTER. THE CALL CENTER ALSO ANSWERS HEALTH QUESTIONS, HELPS PEOPLE LOCATE A PHYSICIAN, REFERS CALLERS TO ADDITIONAL SOURCES OF INFORMATION, AND ENROLLS CALLERS INTO COMMUNITY-FOCUSED CLASSES ON HEALTH-RELATED TOPICS. ADMINISTRATIVE SERVICES INCLUDE HUMAN RESOURCES, PAYROLL, PURCHASING, FINANCE AND ACCOUNTING, PRINTING SERVICES FOR MEDICAL & ADMINISTRATIVE MATERIALS, ORGANIZATIONAL DEVELOPMENT, INTERNAL EDUCATION AND IMPROVEMENT SYSTEMS, QUALITY ASSURANCE FOR BOTH INTERNAL AND PUBLIC REPORTING, MARKETING, COMMUNITY OUTREACH AND EDUCATION PROGRAMS, COMMUNICATION SYSTEMS, SECURITY AND LEGAL COMPLIANCE, AND FULL-SPECTRUM INFORMATION TECHNOLOGY PLANNING & SUPPORT. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 33619473 | Expense |
| Revenue | 41147160 | Revenue |
| Description | THEDACARE'S SENIOR SERVICES DIVISION FOCUSES ON HEALTH CARE FOR CITIZENS EXPERIENCING LONG-TERM HEALTH ISSUES. AT-HOME HEALTH CARE VISITS MAY COMBINE WITH MEDICAL EQUIPMENT RENTALS TO ALLOW SOME PATIENTS TO CONTINUE LIVING IN THEIR OWN HOMES. AN ADULT DAY PROGRAM ALLOWS A CAREGIVER TO WORK OUTSIDE THE HOME WHILE KNOWING THAT THEIR LOVED-ONE IS SAFE WHILE THEY ARE AWAY. INDIVIDUALS WITH GREATER NEEDS MAY UTILIZE OUR ASSISTED LIVING OR LONG-TERM NURSING CARE FACILITIES. CHERRY MEADOWS HOSPICE PROVIDES CARE FOR END-OF-LIFE RESIDENTS IN A DIGNIFIED, COMPASSIONATE ENVIRONMENT. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 12796027 | Expense |
| Revenue | 13770031 | Revenue |
| Description | THEDACARE OFFERS A FULL RANGE OF BEHAVIORAL AND MENTAL HEALTH CARE IN BOTH INPATIENT AND OUTPATIENT SETTINGS. SERVICES INCLUDE PSYCHIATRY, PSYCHOLOGY, BEHAVIORAL MEDICINE, GROUP THERAPY, DAY TREATMENT, DRUG & ALCOHOL ABUSE PROGRAMS FOR BOTH ADULTS AND ADOLESCENTS, INDIVIDUAL OR FAMILY COUNSELING. PROFESSIONAL TREATMENT FOR ADHD, ALZHEIMER'S/DEMENTIA, AND OTHER BEHAVIORAL DISORDERS PROVIDES A RESOURCE FOR ALL SEGMENTS OF OUR COMMUNITY. THEDACARE WORKPLACE SOLUTIONS, A DIVISION OF THEDACARE, PROVIDES OCCUPATIONAL HEALTH SERVICES TO AREA BUSINESSES WITH THE GOAL OF HELPING TO CONTROL THE COST OF INSURING THEIR EMPLOYEES. INDENTIFYING AND MANAGING CHRONIC DISEASE HELPS KEEP A WORKFORCE HEALTHY AND PRODUCTIVE, BENEFITTING BOTH COMMUNITY AND EMPLOYER. EMPLOYEE ASSIST PROGRAMS, ON-SITE MEDICAL SERVICE PROVIDERS, ERGONOMICS, IMMUNIZATIONS AND SCREENINGS, SAFETY EDUCATION AND INJURY PREVENTION ALL CONTRIBUTE TO MAINTAINING THE HEALTH AND WELL-BEING OF INDIVIDUALS WHO MAKE UP OUR WORKFORCE. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 12796027 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 13770031 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 241291415 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 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 | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 428 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 6579 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 1 | ForeignFinancialAccount |
| Name Of Foreign Country | CJ | NameOfForeignCountry |
| 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 | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | 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 | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | 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 | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedure |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KRISTEN COGSWELL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9207386471 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 122 E COLLEGE AVENUE | AddressLine1 |
| City | APPLETON | City |
| State | WI | State |
| ZIP Code | 54911 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (25 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| DEAN A GRUNER MD | ||||||||
| PRESIDENT AND CEO | 40.00 | X | X | 227488 | 682465 | 165240 | ||
| KATHLEEN M QUALHEIM MD | ||||||||
| TRUSTEE, PHYS | 40.00 | X | 436086 | 0 | 22397 | |||
| DAVID ANDERLA MD | ||||||||
| TRUSTEE, PHYS | 40.00 | X | 312073 | 0 | 23150 | |||
| OMAR ATASSI MD | ||||||||
| BOARD TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| DOUGLAS MOARD MD | ||||||||
| TRUSTEE, PHYS | 40.00 | X | 252753 | 0 | 21762 | |||
| GINGER JONES | ||||||||
| BOARD TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| JIM LARSON | ||||||||
| BOARD TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| MARK RICHARDS | ||||||||
| BOARD TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| WALT RUGLAND | ||||||||
| BOARD TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| MARK SCOTT | ||||||||
| BOARD TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| JON STELLMACHER | ||||||||
| CHAIRMAN | 2.00 | X | X | 0 | 0 | 0 | ||
| JACK SWANSON MD | ||||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | ||
| MIKE WELLER | ||||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 | ||
| JEFFREY WHITESIDE MD | ||||||||
| BOARD TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| EILEEN CONNOLLY-KEESLER | ||||||||
| BOARD TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| TIM A OLSON | ||||||||
| SR. VP, CFO | 40.00 | X | 108404 | 325213 | 99752 | |||
| ROSELLEN CROW | ||||||||
| SR. VP HOMECARE | 40.00 | 99128 | 396511 | 18653 | X | |||
| BRIAN R BURMEISTER | ||||||||
| COO, SR. VP PHY | 40.00 | 148269 | 148269 | 52124 | X | |||
| KEITH J LIVINGSTON | ||||||||
| SR. VP, CIO | 40.00 | 94412 | 283237 | 80840 | X | |||
| MAUREEN PISTONE | ||||||||
| VP HUMAN SERVICES | 40.00 | 74698 | 224097 | 72533 | X | |||
| KATHRYN CORREIA | ||||||||
| VP, SR., HOSPITAL SERVICES | 40.00 | 52167 | 469506 | 96773 | X | |||
| ERIC W ERICKSON MD | ||||||||
| PHYSICIAN | 40.00 | 1371308 | 0 | 23927 | X | |||
| TODD B SMITH MD | ||||||||
| PHYSICIAN | 40.00 | 788093 | 0 | 22777 | X | |||
| KENNETH KLEIST | ||||||||
| PHYSICIAN | 40.00 | 701029 | 0 | 22917 | X | |||
| JEFFERY MINIKEL MD | ||||||||
| PHYSICIAN | 40.00 | 468955 | 0 | 18618 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 5134863 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2529298 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 741463 | TotalOtherCompensation |
| Number Individuals GT100 K | 226 | 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 |
|---|---|---|---|---|---|
| ENTERPRISE SYSTEMS SOFTWARE | |||||
| 5151 MONROE STREET 101 | TOLEDO | OH | 43623 | SOFTWARE | 972926 |
| BELLIN HEALTH SYSTEM | |||||
| PO BOX 23400 | GREEN BAY | WI | 543053400 | HEALTH | 899256 |
| GODFREY & KAHN SC | |||||
| 780 N WATER ST | MILWAUKEE | WI | 532023590 | LEGAL | 675481 |
| THE REVERE GROUP LTD | |||||
| 2166 PAYSPHERE CIRCLE | CHICAGO | IL | 60674 | BUSINESS ADVISOR | 647979 |
| E-FREIGHT COURIER LLP | |||||
| PO BOX 13885 | WAUWATOSA | WI | 532130885 | FREIGHT | 412962 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 17 | NumberOfContractorsGT100K |
| Related Organizations | 66881 | RelatedOrganizations |
| All Other Contributions | 110468 | AllOtherContributions |
| Total Contributions | 177349 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| PATIENT/CLIENT REVENUE | 900099 | 171837973 | 171837973 | |
| MANAGEMENT SERVICE FEE | 900099 | 70905893 | 70905893 | |
| SOFTWARE SERVICES | 541511 | 4405804 | 4405804 | |
| DURABLE MEDICAL EQUIP | 621610 | 97505 | 97505 | |
| DURABLE MEDICAL EQUIP | 621610 | 70003 | 70003 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 247317178 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4866400 | TotalRevenueColumn |
| Exclusion | $4,866,400 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1941287 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1769920 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 171367 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 171367 | TotalRevenueColumn |
| Related Or Exempt Function Income | 171367 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 246985947 | Securities |
| Other | 46612 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 240563258 | Securities |
| Other | 33355 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6422689 | Securities |
| Other | 13257 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6435946 | TotalRevenueColumn |
| Exclusion | $6,435,946 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| OTHER MISC | 900009 | 1826783 | 1826783 | |
| INFORMATION TECHNOLOGY | 900099 | 1716958 | 1716958 | |
| EQUITY GAIN IN AFFILIA | 900099 | 448538 | $448,538 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1560730 | TotalRevenueColumn |
| Exclusion | $1,560,730 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 5553009 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 264521249 | TotalRevenueColumn |
| Related Or Exempt Function Income | 246458974 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 4573312 | UnrelatedBusinessRevenue |
| Exclusion | $13,311,614 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 722750 | Total |
| Program Services | 722750 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2513098 | Total |
| Program Services | 1000913 | ProgramServices |
| Management And General | 1512185 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 142262802 | Total |
| Program Services | 133134639 | ProgramServices |
| Management And General | 9128163 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6723112 | Total |
| Program Services | 5266567 | ProgramServices |
| Management And General | 1456545 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19611806 | Total |
| Program Services | 14454330 | ProgramServices |
| Management And General | 5157476 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7782704 | Total |
| Program Services | 6658570 | ProgramServices |
| Management And General | 1124134 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 851334 | Total |
| Program Services | 80973 | ProgramServices |
| Management And General | 770361 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 777523 | Total |
| Program Services | 615389 | ProgramServices |
| Management And General | 162134 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 242143 | Total |
| Management And General | 242143 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 535582 | Total |
| Management And General | 535582 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4571197 | Total |
| Program Services | 4388110 | ProgramServices |
| Management And General | 183087 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2397991 | Total |
| Program Services | 1516809 | ProgramServices |
| Management And General | 881182 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2081044 | Total |
| Program Services | 1662079 | ProgramServices |
| Management And General | 418965 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8168774 | Total |
| Program Services | 6535019 | ProgramServices |
| Management And General | 1633755 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12077739 | Total |
| Program Services | 11243687 | ProgramServices |
| Management And General | 834052 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1160305 | Total |
| Program Services | 1100539 | ProgramServices |
| Management And General | 59766 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1370909 | Total |
| Program Services | 1257475 | ProgramServices |
| Management And General | 113434 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1402436 | Total |
| Program Services | 1402436 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6809533 | Total |
| Program Services | 6714022 | ProgramServices |
| Management And General | 95511 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1177206 | Total |
| Program Services | 1033944 | ProgramServices |
| Management And General | 143262 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 14280454 | 14236714 | 43740 |
| PURCHASED SERVICES | 10655285 | 10193762 | 461523 |
| COST OF GOODS SOLD | 6324591 | 6324591 | |
| BAD DEBT EXPENSE | 4533027 | 4523506 | 9521 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7650840 | Total |
| Program Services | 7224591 | ProgramServices |
| Management And General | 426249 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 266684185 | Total |
| Program Services | 241291415 | ProgramServices |
| Management And General | 25392770 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34234031 | BOY |
| EOY | 60242270 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23422156 | BOY |
| EOY | 22566778 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 623666 | BOY |
| EOY | 686851 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10554542 | BOY |
| EOY | 11086141 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 204399793 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 113126252 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 103339546 | BOY |
| EOY | 91273541 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42006440 | BOY |
| EOY | 222180786 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27118487 | BOY |
| EOY | 25096005 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 241298868 | BOY |
| EOY | 433132372 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55061075 | BOY |
| EOY | 64248434 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1288067 | BOY |
| EOY | 2220885 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 249940000 | BOY |
| EOY | 242715000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14936629 | BOY |
| EOY | 13081131 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 138361683 | BOY |
| EOY | 373924922 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 459587454 | BOY |
| EOY | 696190372 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -218288586 | BOY |
| EOY | -263058000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -218288586 | BOY |
| EOY | -263058000 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 241298868 | BOY |
| EOY | 433132372 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -2162936 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -42606478 | 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 Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type3 Func Int | X | SupportingOrg509a3Type3FuncInt |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (5 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| THEDA CLARK MEDICAL CENTER INC | |||||
| 390830664 | 3 | 0 | 1 | 1 | $0 |
| APPLETON MEDICAL CENTER INC | |||||
| 390824015 | 3 | 0 | 1 | 1 | $0 |
| NEW LONDON FAMILY MEDICAL CENTER INC | |||||
| 390869788 | 3 | 0 | 1 | 1 | $0 |
| RIVERSIDE MEDICAL CENTER INC | |||||
| 390871113 | 3 | 0 | 1 | 1 | $0 |
| SHAWANO MEDICAL CENTER INC | |||||
| 390807068 | 3 | 0 | 1 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 5 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
| General Explanation | SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SUPPLEMENTAL INFORMATION THEDACARE INC. PROVIDES FUNCTIONS SUCH AS PURCHASING, FINANCE, BILLING, BANKING, HUMAN RESOURCES, INFORMATION TECHNOLOGY, QUALITY ASSURANCE, EDUCATION AND REFERENCE LABORATORY TO THE SUPPORTED ORGANIZATIONS LISTED ON SCHEDULE A. CONSOLIDATED ACCOUNTING PROVIDES DIRECT REVENUE AND EXPENSE REPORTING BY ORGANIZATION, WITH ONGOING INTERCOMPANY BALANCES REPLACING THE USE OF CASH TRANSFERS TO REIMBURSE AFFILIATES. | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 1 | MailingsMembers |
| Mailings Members | $6,859 | MailingsMembersAmount |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 6859 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | LOBBYING ACTIVITIES WERE DONE TO INFLUENCE THE STATE OF WI GOVERNING BODY. NO EFFORT WAS MADE TO THE FEDERAL GOVERNMENT, OR TO SUPPORT ANY CANDIDATE. SEE DETAIL OF LOBBYING EXPENDITURES ONLINE AT HTTP://ETHICS.STATE.WI.US ITEMS THAT WERE LOBBIED INCLUDE: -PROHIBITING REFUSAL TO HONOR ANATOMICAL GIFT DIRECTIVE -ASSISTED LIVING, NURSING HOME AND HOSPICE CARE POLICIES -CONSTRUCTION STANDARDS FOR HOSPITALS -GIFTS GIVEN OR OFFERED BY PRESCRIPTION DRUG MANUFACTURERS/DISTRIBUTORS -HEALTH AND FAMILY SERVICES: MEDICAL ASSISTANCE -HOSPITAL ASSESSMENT/TAX -HEALTH CARE RECORDS -HEALTH CARE REFORM, INCLUDING QUALITY OF CARE INITIATIVES -FEES FOR COPIES OF PATIENT HEALTH CARE RECORDS -HOSPITAL COSTS -ASSESSMENT ON GROSS PRIVATE PATIENT REVENUE OF HOSPITALS -MEDICAL ASSISTANCE AND BADGER CARE PAYMENT RATE FOR HOSPITALS -REGULATION OF HOSPITALS -ADVERTISING FOR PRESCRIPTION DRUGS -ELIMINATING AN ASSESSMENT ON THE GROSS PRIVATE PATIENT REVENUE OF HOSPITALS -THE ESTABLISHMENT OF THE HEALTHY WISCONSIN PLAN AND THE HEALTH WISCONSIN AUTHORITY, GRANTING RULE-MAKING AUTHORITY, AND MAKING AN APPROPRIATION | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8217603 | OtherCostOrOtherBasis |
| Book Value | 8217603 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 72033832 | OtherCostOrOtherBasis |
| Depreciation | 22805175 | Depreciation |
| Book Value | 49228657 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 678348 | OtherCostOrOtherBasis |
| Depreciation | 267279 | Depreciation |
| Book Value | 411069 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 116573205 | OtherCostOrOtherBasis |
| Depreciation | 90053798 | Depreciation |
| Book Value | 26519407 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6896805 | OtherCostOrOtherBasis |
| Book Value | 6896805 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 91273541 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| CAPITAL FUNDS COMMITTED TO HOSPITAL | 20977978 |
| LICENSE FEES- NET OF AMORTIZATION | 4118027 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 25096005 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO AFFILIATES | $303,191,467 |
| DEFERRED EMPLOYEE BENEFITS | $69,674,139 |
| LONG TERM DEBT-ARO ACCRETION | $1,059,316 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 373924922 | TotalOfAmounts |
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 | THEDACARE FOLLOWS FASB GUIDANCE ON INCOME TAXES, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THIS GUIDANCE, THEDACARE MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. EXAMPLES OF TAX POSITIONS INCLUDE THE TAX-EXEMPT STATUS OF THEDACARE, AND VARIOUS POSITIONS RELATED TO THE POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (UBIT). THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50 PERCENT LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. AT DECEMBER 31, 2011 AND 2010, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES. THEDACARE FILES FORM 990 IN THE U.S. FEDERAL JURISDICTION. TAX RETURNS FILED BY THEDACARE ARE GENERALLY OPEN FOR EXAMINATION FOR THE YEARS 2008 THROUGH 2011. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| THEDACARE CENTER FOR CREATING VALUE | |||||||
| 100 W LAWRENCE ST | APPLETON | WI | 54911 | 262795800 | 501 (C) (3) | 625000 | GENERAL |
| FOX CITIES COMMUNITY HEALTH CENTER | |||||||
| 1814 APPLETON ROAD | MENASHA | WI | 54952 | 202090446 | 501 (C) (3) | 52500 | GENERAL |
| THEDA CLARK MEDICAL CENTER FOUNDATION | |||||||
| 130 SECOND ST | NEENAH | WI | 54956 | 311550056 | 501 (C) (3) | 11100 | GENERAL |
| WOLF RIVER AREA HEALTH CARE FOUNDATION | |||||||
| 1405 MILL ST | NEW LONDON | WI | 54961 | 200049796 | 501 (C) (3) | 7000 | GENERAL |
| COMMUNITY HOSPICE FOUNDATION INC | |||||||
| PO BOX 1534 | APPLETON | WI | 54912 | 391511977 | 501 (C) (3) | 6700 | GENERAL |
| APPLETON MEDICAL CENTER FOUNDATION INC | |||||||
| 1818 NORTH MEADE STREET | APPLETON | WI | 54911 | 391459276 | 501 (C) (3) | 14450 | GENERAL |
| GEORGE F PEABODY FOUNDATION | |||||||
| PO BOX 1534 | APPLETON | WI | 54912 | 391702534 | 501 (C) (3) | 6000 | GENERAL |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 7 | TotalNbrOf501C3AndGovtGrants |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DEAN A GRUNER MD | |||||||||||||
| 166750 | 500250 | 58819 | 176457 | 1919 | 5758 | 37887 | 113662 | 3423 | 10268 | 268798 | 806395 | 0 | 0 |
| KATHLEEN M QUALHEIM MD | |||||||||||||
| 433141 | 0 | 356 | 0 | 2589 | 0 | 9350 | 0 | 13047 | 0 | 458483 | 0 | 0 | 0 |
| DAVID ANDERLA MD | |||||||||||||
| 311184 | 0 | 356 | 0 | 533 | 0 | 9350 | 0 | 13800 | 0 | 335223 | 0 | 0 | 0 |
| DOUGLAS MOARD MD | |||||||||||||
| 252397 | 0 | 356 | 0 | 0 | 0 | 9350 | 0 | 12412 | 0 | 274515 | 0 | 0 | 0 |
| TIM A OLSON | |||||||||||||
| 86162 | 258487 | 15635 | 46905 | 6607 | 19821 | 21638 | 64913 | 3300 | 9901 | 133342 | 400027 | 0 | 0 |
| ROSELLEN CROW | |||||||||||||
| 62358 | 249431 | 11870 | 47480 | 24900 | 99600 | 2576 | 10304 | 1155 | 4618 | 102859 | 411433 | 0 | 0 |
| BRIAN R BURMEISTER | |||||||||||||
| 116979 | 116979 | 21325 | 21325 | 9965 | 9965 | 19078 | 19078 | 6984 | 6984 | 174331 | 174331 | 0 | 0 |
| KEITH J LIVINGSTON | |||||||||||||
| 75623 | 226869 | 13723 | 41169 | 5066 | 15199 | 16937 | 50812 | 3273 | 9818 | 114622 | 343867 | 0 | 0 |
| MAUREEN PISTONE | |||||||||||||
| 60771 | 182314 | 11027 | 33082 | 2900 | 8701 | 14899 | 44697 | 3234 | 9703 | 92831 | 278497 | 0 | 0 |
| KATHRYN CORREIA | |||||||||||||
| 39934 | 359409 | 10869 | 97825 | 1364 | 12272 | 8237 | 74135 | 1440 | 12961 | 61844 | 556602 | 0 | 0 |
| ERIC W ERICKSON MD | |||||||||||||
| 582555 | 0 | 787728 | 0 | 1025 | 0 | 9350 | 0 | 14577 | 0 | 1395235 | 0 | 0 | 0 |
| TODD B SMITH MD | |||||||||||||
| 499999 | 0 | 287068 | 0 | 1026 | 0 | 9350 | 0 | 13427 | 0 | 810870 | 0 | 0 | 0 |
| KENNETH KLEIST | |||||||||||||
| 700003 | 0 | 0 | 0 | 1026 | 0 | 9350 | 0 | 13567 | 0 | 723946 | 0 | 0 | 0 |
| JEFFERY MINIKEL MD | |||||||||||||
| 442299 | 0 | 20000 | 0 | 6656 | 0 | 7350 | 0 | 11268 | 0 | 487573 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | EXECUTIVES RECEIVE REIMBURSEMENT FOR PERSONAL MEDICAL EXPENSES AT AN AMOUNT GROSSED-UP FOR TAXES. ALL EXECUTIVES IN THE SENIOR MANAGEMENT BENEFIT CATEGORY ARE ELIGIBLE TO HAVE HEALTH OR FITNESS CLUB FEES PAID DIRECTLY TO THE CLUB, OR REIMBURSED TO THEM ON EVIDENCE OF PAYMENT. SENIOR EXECUTIVES WHOSE DUTIES INCLUDE MEETING WITH PEOPLE OUTSIDE THE COMPANY FOR PURPOSED OF DEVELOPING BUSINESS RELATIONSHIPS HAVE COMPANY PAID MEMBERSHIPS AT A LOCAL COUNTRY CLUB. 32 EMPLOYEES RECEIVED TAXABLE MEDICAL EXPENSE REIMBURSEMENTS AND 19 EMPLOYEES RECEIVED CLUB DUES REIMBURSEMENTS. |
| PART I, LINE 4B | NONQUALIFIED PLAN DESCRIPTION SENIOR LEVEL EXECUTIVES OF THE COMPANY ARE ENTITLED TO AN ANNUAL FLEXIBLE BENEFIT EQUAL TO 20% OF THE MIDPOINT OF THEIR SALARY RANGE. THIS 457(F) SUPPLEMENTAL BENEFIT PLAN COMPLIES WITH THE FINAL REGULATIONS UNDER SECTION 409A AND 457(F) OF THE INTERNAL REVENUE CODE. PARTICIPANTS MAY ELECT THE BENEFIT TO BE USED TO PURCHASE PARTICULAR INSURANCE BENEFITS, INVESTED IN A CAPITAL ACCUMULATION ACCOUNT, OR A COMBINATION OF THE TWO. BENEFITS ARE ACCRUED ON A MONTHLY BASIS AND ARE SUBJECT TO THE SUBSTANTIAL RISK OF FORFEITURE AGREEMENT SIGNED BY THE PARTICIPANTS. PLAN CONTRIBUTIONS ARE MADE ON A QUARTERLY BASIS. |
| PART I, LINE 7 | EXECUTIVE AT RISK COMPENSATION PLAN THE PLAN OBJECTIVES ARE TO ENHANCE THEDACARE INC'S ABILITY TO ACHIEVE ITS GOALS BY PROVIDING A TOOL FOR STIMULATING AND REWARDING SUPERIOR LEVELS OF PERFORMANCE AMONG KEY EXECUTIVES, IMPROVE THEDACARE INC'S ABILITY TO COMPETE WITH OTHER EMPLOYERS FOR HIGH TALENT EXECUTIVES AND TO ENCOURAGE TOP-LEVEL EXECUTIVES TO WORK TOGETHER AS A COHESIVE GROUP TOWARD COMMON GOALS. THE PRESIDENT OF THEDACARE INC. DEVELOPS A LIST OF SENIOR LEVEL EXECUTIVES WHO ARE ELIGIBLE TO PARTICIPATE IN THIS PLAN, AS WELL AS THE PERFORMANCE LEVELS THE SENIOR EXECUTIVES MUST ACHIEVE AND THE AT-RISK COMPENSATION AMOUNTS THAT THE EXECUTIVES WILL RECEIVE. THE PRESIDENT THEN SUBMITS THIS LIST TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES FOR FINAL APPROVAL. THESE EXECUTIVES MUST BE IN ACTIVE REGULAR SERVICE OF THEDACARE INC. FOR THE ENTIRE PLAN YEAR (JANUARY 1, 2011 TO DECEMBER 31, 2011) TO RECEIVE THEIR 2011 AT-RISK COMPENSATION. IF THE EMPLOYEE RETIRES, BECOMES DISABLED, MOVES TO A POSITION THAT IS ELIGIBLE UNDER THE AT-RISK COMPENSATION PLAN OR MOVES TO A POSITION THAT IS NO LONGER ELIGIBLE FOR THE AT-RISK COMPENSATION PLAN OR DIES THE PLAN WILL BE PRORATED FOR THE AMOUNT OF TIME THEY SERVED THE COMPANY. IF AN ELIGIBLE EMPLOYEE IS FIRED OR LEAVES THE COMPANY FOR ANY OTHER REASON THE PLAN AT-RISK COMPENSATION EARNED WILL BE FORFEITED. CARING FOR SUCCESS THE PLAN OBJECTIVES ARE TO PROVIDE INCENTIVE TO FOCUS THE ORGANIZATION'S RESOURCES, ENERGY AND ATTENTION ON THE FULFILLMENT OF THEDACARE'S MISSION. THE ORGANIZATIONAL MEASURE IS THEDACARE'S OPERATING PERFORMANCE AND EMPLOYEES HEALTH ASSESSMENT TOOL SCORE IMPROVEMENTS. ALL ELIGIBLE EMPLOYEES (ON THE PAYROLL AS OF JULY 1, 2011 AND STILL BE ON THE PAYROLL AS OF MARCH 15, 2012) SHARE IN THE GAIN. THE PAYOUT AMOUNT IS DETERMINED BASED ON THEDACARE'S OPERATING MARGIN AND REDUCTION IN OSHA RECORDABLE STRAINS AND SPRAINS. THE AMOUNT PER EMPLOYEE IS DETERMINED BY DIVIDING THE TOTAL GAIN REALIZED (THE EMPLOYEE SHARE) BY HOURS PAID TO ALL ELIGIBLE EMPLOYEES. THE RESULTING DOLLAR UNIT PAYOUT IS MULTIPLIED BY AN INDIVIDUAL EMPLOYEE'S NUMBER OF HOURS PAID. THIS PLAN IS OVERSEEN BY AN ADMINISTRATIVE COMMITTEE. THE THEDACARE BOARD OF TRUSTEES MUST APPROVE THE PLAN. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| WHEFA REV BOND 2005 | |||||||
| 391337895 | 97710VZH4 | 2005-12-22 | 59289833 | FACILITY CONSTRUCTION | 0 | 0 | 0 |
| WHEFA REV BOND 2009A | |||||||
| 391337855 | 97710BHY1 | 2009-06-16 | 87896508 | FACILITY CONSTRUCTION RENOVATION AND REMODELING | 0 | 0 | 0 |
| WHEFA REV BOND 2009B | |||||||
| 391337855 | 97710BJL7 | 2009-06-16 | 36717948 | REFUNDING | 0 | 0 | 0 |
| WHEFA REV BOND 2010 | |||||||
| 391337855 | 97710BVM1 | 2010-05-25 | 25345018 | REFUNDING | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)
| Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Capitalized InterestCapitalizedInterest | Other Spent ProceedsOtherSpentProceeds |
|---|---|---|---|---|---|---|---|---|---|---|
| 59289833 | 4350000 | 507610 | 53675584 | 2007 | 0 | 0 | 1 | 1 | ||
| 87896508 | 5373000 | 1018634 | 81260000 | 2010 | 0 | 0 | 1 | 1 | 4916000 | |
| 36717948 | 1589000 | 425525 | 1 | 0 | 1 | 1 | 34599423 | |||
| 25345018 | 332397 | 1 | 0 | 1 | 1 | 25012621 |
Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Term Of GICTermOfGIC | Regulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|---|---|
| FIFTH THIRD BANK | |||||||
| 0 | 0 | 0 | 1 | 1.000000000000 | 1 | 0 | 0 |
| (no name) | |||||||
| 0 | 0 | 0 | 0 | 0 | 0 | ||
| (no name) | |||||||
| 0 | 0 | 0 | 0 | 0 | 0 | ||
| (no name) | |||||||
| 0 | 0 | 0 | 0 | 0 | 0 | ||
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | ORGANIZATION'S PROCESS USED TO REVIEW FORM 990: A DRAFT OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S DESIGNATED COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION AT A BOARD MEETING. THE FINAL VERSION OF THE FORM 990 IS EMAILED TO THE ENTIRE BOARD BEFORE THE RETURN IS FILED. | |
| FORM 990, PART VI, SECTION B, LINE 12C | QUESTIONNAIRES ARE SENT TO ALL MANAGERS, TRUSTEES AND OFFICERS ANNUALLY. COMPLETED FORMS ARE RETURNED TO THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER REVIEWS THE QUESTIONNAIRES AND FOLLOWS UP WITH ANY QUESTIONS ABOUT THE MANAGERS' ANSWERS ON THE CONFLICT OF INTEREST FORMS. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THEDACARE HIRES AN OUTSIDE CONSULTING FIRM TO CONDUCT A THOROUGH MARKET REVIEW OF EXECUTIVE COMPENSATION EVERY OTHER YEAR. INTERNALLY, A COMPENSATION COMMITTEE REAFFIRMS THE COMPENSATION POLICY, REVIEWS DATA FROM CONSULTANTS, AND WITH INPUT FROM THE SR VP OF HUMAN RESOURCES, ADVISES, VALIDATES, AND APPROVES A RANGE FOR CEO COMPENSATION. THE COMMITTEE ALSO RATIFIES THE AT-RISK COMPENSATION PLAN. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THEDACARE INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND INTERNAL FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. | |
| PART VI, SECTION B, LINE 16B: | THEDACARE CONSULTS WITH LEGAL COUNSEL TO ENSURE SAFEGUARDING OF THE TAX-EXEMPT STATUS. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -13,699,125. PENSION RELATED CHANGES -28,934,685. ASSETS RELEASED FROM RESTRICTION 27,332. TOTAL TO FORM 990, PART XI, LINE 5: -42,606,478. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FROM 990, PART XII, LINE 2C: | THE PROCESS DID NOT CHANGE DURING THE YEAR. | |
| FROM 990, PART I, LINE 5: | THEDACARE INC. CENTRALIZES PAYROLL AND TAX WITHHOLDING FUNCTIONS FOR A NUMBER OF AFFILIATED ENTITIES, WITH ALL FILINGS UNDER THEDACARE'S FEDERAL IDENTIFICATION NUMBER. | NUMBER OF EMPLOYEES |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| APPLETON MEDICAL CENTER | ||||||||||
| PO BOX 8025 | APPLETON | WI | 54912 | 390824015 | HOSPITAL | WI | 501(C)(3) | LINE 3 | THEDACARE | 0 |
| THEDA CLARK MEDICAL CENTER | ||||||||||
| PO BOX 8025 | APPLETON | WI | 54912 | 390830664 | HOSPITAL | WI | 501(C)(3) | LINE 3 | THEDACARE | 0 |
| APPLETON MEDICAL CENTER FOUNDATION | ||||||||||
| 1818 N MEADE | APPLETON | WI | 54911 | 391459276 | FOUNDATION | WI | 501(C)(3) | LINE 7 | THEDACARE | 0 |
| THEDA CLARK MEDICAL CENTER FOUNDATION | ||||||||||
| 130 SECOND STREET | NEENAH | WI | 54956 | 391550056 | FOUNDATION | WI | 501(C)(3) | LINE 7 | THEDACARE | 0 |
| WOLF RIVER AREA HEALTHCARE FOUNDATION | ||||||||||
| 1405 MILL STREET | NEW LONDON | WI | 54961 | 200049796 | FOUNDATION | WI | 501(C)(3) | LINE 11B, II | THEDACARE | 0 |
| COMMUNITY HOSPICE FOUNDATION | ||||||||||
| 1818 N MEADE | APPLETON | WI | 54911 | 391511977 | FOUNDATION | WI | 501(C)(3) | LINE 7 | THEDACARE | 0 |
| GEORGE F PEABODY FOUNDATION | ||||||||||
| PO BOX 2553 | APPLETON | WI | 54912 | 391702534 | FOUNDATION | WI | 501(C)(3) | LINE 11A, I | THEDACARE | 0 |
| NEW LONDON FAMILY MEDICAL CENTER | ||||||||||
| 1405 MILL STREET | NEW LONDON | WI | 54961 | 390869788 | HOSPITAL | WI | 501(C)(3) | LINE 3 | THEDACARE | 0 |
| RIVERSIDE MEDICAL CENTER INC | ||||||||||
| 800 RIVERSIDE DRIVE | WAUPACA | WI | 54891 | 390871113 | HOSPITAL | WI | 501(C)(3) | LINE 3 | THEDACARE | 0 |
| SHAWANO MEDICAL CENTER INC | ||||||||||
| 309 N BARTLETTE STREET | SHAWANO | WI | 54166 | 390807068 | HOSPITAL | WI | 501(C)(3) | LINE 3 | THEDACARE | 0 |
| SHAWANO MEDICAL CENTER FOUNDATION INC | ||||||||||
| 309 N BARTLETTE STREET | SHAWANO | WI | 54166 | 391539117 | FOUNDATION | WI | 501(C)(3) | LINE 11D, III-O | THEDACARE | 0 |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AYLWARD CLINICAL SERVICES CO LLC | |||||||||||||
| PO BOX 2021 | NEENAH | WI | 54956 | 204202274 | MGMT SERVICE | WI | N/A | RELATED | 114819 | 774857 | 0 | 1 | 0.50000 |
| GROTH CLINICAL SERVICES CO LLC | |||||||||||||
| 1818 N MEADE ST | APPLETON | WI | 54911 | 204202228 | MGMT SERVICE | WI | N/A | RELATED | 644382 | 1484990 | 0 | 1 | 0.50000 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PREMIUM HEALTHCARE INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8025 | AddressLine1 |
| City | APPLETON | City |
| State | WI | State |
| ZIP Code | 54912 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200120381 | EIN |
| Primary Activity | CONT ADMIN | PrimaryActivity |
| Legal Domicile State | WI | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | -16751 | ShareOfTotalIncome |
| Share Of EOY Assets | 42616 | ShareOfEOYAssets |
| Percentage Ownership | 0.50000 | PercentageOwnership |
| 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 | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |