VERNON MEMORIAL HEALTHCARE INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
VERNON MEMORIAL HEALTHCARE INC (EIN 39-0806404)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-07-05
IRS object ID
201121869349300112
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-07-05T09:18:42-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13703 OAKWOOD HILLS PARKWAYAddressLine1
CityEAU CLAIRECity
StateWIState
ZIP Code54701ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390806404EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Vernon Memorial Healthcare incBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlVERNNameControl
Phone6086372101Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1507 South Main StreetAddressLine1
CityVIROQUACity
StateWIState
ZIP Code54665ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMary KoenigName
TitleCFOTitle
Phone6086372101Phone
Date Signed2011-07-05DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameHolly Pokrandt CPAName
Phone7158323407Phone
Date Prepared2011-06-30DatePrepared
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMary KoenigNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1507 South Main StreetAddressLine1
CityVIROQUACity
StateWIState
ZIP Code54665ZIPCode
FieldValueIRS element (for citing)
Gross Receipts66954357GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.vmh.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1946YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionVernon Memorial Healthcare has been committed to providing the highest quality care and treatment to the injured, afflicted and well people who need the resources we have at our command, without regard to race, creed, color, sex, handicap, national origin, or ability to pay. It is our intention to insure that in each and every case our patients shall be treated with compassion, understanding and dignity. Further, the rights and privileges of the people we serve shall always be held in the highest regard, and their well-being must always have first consideration. Vernon Memorial Healthcare is committed to providing modern facilities and equipment consistent with new and contemporary medical technology. We will foster, stimulate, encourage and promote continuing healthcare education for employees and the community we serve. All this, we most solemnly and sincerely pledge to the people who need us, recognizing fully, that service to humanity is the greatest service of all.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees565TotalNbrEmployees
Total Nbr Volunteers200TotalNbrVolunteers
Total Gross UBI5803330TotalGrossUBI
Net Unrelated Business Txbl Income-416711NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year58661ContributionsGrantsPriorYear
Contributions Grants Current Year96235ContributionsGrantsCurrentYear
Program Service Revenue Prior Year62763321ProgramServiceRevenuePriorYear
Program Service Revenue CY64672978ProgramServiceRevenueCY
Investment Income Prior Year431281InvestmentIncomePriorYear
Investment Income Current Year556618InvestmentIncomeCurrentYear
Other Revenue Prior Year179695OtherRevenuePriorYear
Other Revenue Current Year236480OtherRevenueCurrentYear
Total Revenue Prior Year63432958TotalRevenuePriorYear
Total Revenue Current Year65562311TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year174000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY157238GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year29036701SalariesEtcPriorYear
Salaries Etc Current Year31403220SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year29780049OtherExpensePriorYear
Other Expenses Current Year29178727OtherExpensesCurrentYear
Total Expenses Prior Year58990750TotalExpensesPriorYear
Total Expenses Current Year60739185TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4442208RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4823126RevenuesLessExpensesCY
Total Assets BOY67975886TotalAssetsBOY
Total Assets EOY72396251TotalAssetsEOY
Total Liabilities BOY31733375TotalLiabilitiesBOY
Total Liabilities EOY31548662TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY36242511NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY40847589NetAssetsOrFundBalancesEOY
Mission DescriptionVERNON MEMORIAL HEALTHCARE, Inc. WILL STRIVE TO HAVE THE VISION TO CONTINUALLY PROVIDE THE HIGHEST STANDARD OF CARE TO OUR PATIENTS AND THEIR FAMILIES WHILE BEING 'CLOSE TO HOME.' OUR MISSION IS TO PROVIDE COST-EFFECTIVE, ACCESSIBLE CARE AND SERVICE USING PROFESSIONALLY EDUCATED STAFF AND SUPERIOR TECHNOLOGY TO MEET THE HEALTH CARE NEEDS OF OUR COMMUNITY. OUR CARING AND COMMITMENT TO THE COMMUNITY WILL BE DEMONSTRATED BY OUR EMPHASIS ON HEALTH PROMOTION AND DISEASE PREVENTION THROUGH EDUCATION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense44057335Expense
Grants157238Grants
Revenue47915349Revenue
DescriptionWhile there is a growing agreement in the United States about what constitutes a non-profit healthcare organization's community benefit, this is a work in progress. Our organization provides significant charity care and other community benefits as defined by the IRS. But in addition, we believe that we provide a critically important community benefit which cannot be quantified. Our organization was created and is maintained in order to provide care locally-care that without the presence of our organization, would not be available to the people in our service area.Beyond medical, obstetrical, newborn and surgical inpatient hospitalizations, we provide local access to many other health services including a birthing center, a dialysis center, diagnostic services-laboratory, imaging and cardiac testing, 24-hour emergency services, urgent care services, infusion services, gastrointestinal services, home health care, hospice, inpatient and outpatient care, rehabilitation services-physical, occupational, respiratory and speech therapy, specialty medicine, and primary care clinics.In 2010, hospital inpatient services included 4,401 acute care patient days, 46 swing bed patient days, and 358 newborn patient days. There were 1,555 surgery cases, 6,334 emergency room visits, and 1,154 visits to the after hours clinic.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense9316310Expense
Revenue10120636Revenue
DescriptionA total of 45,446 clinic visits occurred in FYE 2010 at the four clinics located in Viroqua, LaFarge, Soldiers Grove, and Westby.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1178422Expense
Revenue833663Revenue
DescriptionDuring FYE 2010, 1,938 home health visits were made to 82 individuals. Hospice care was provided to 72 individuals for a total of 3,232 days.Description
FieldValueIRS element (for citing)
Total Program Service Expense54552067TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109643NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees565NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons0AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement0RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Mary KoenigBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6086372101TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1507 South Main StreetAddressLine1
CityVIROQUACity
StateWIState
ZIP Code54665ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Phyllis Malin
Member1.00X000
Tim Gaskell
Member1.00X000
Enid Neubauer
Member1.00X000
James Larson
Treasurer1.00X000X
Chet Lee
Member1.00X000
Ron Moilien
Vice Chair1.00X000X
Jerry Moran
Member1.00X000
Judy Schmirler
Member1.00X000
Brad Steinmetz
Chairman2.00X000X
John Young
Secretary1.00X000X
Garith Steiner
CEO40.00284356028010X
Mary Koenig
CFO40.00187573018952X
Kyle Bakkum
COO40.00186210021888X
Dr Jeffrey menn
Physician40.00440544027276X
Dr Brian Woody
Physician40.00261531027083X
Dr Duane Koons
Physician40.00250454026910X
Dr Deborah Prior
Physician40.00239869025483X
Brian Miller
CRNA40.00304987022848X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2155524TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation198450TotalOtherCompensation
Number Individuals GT100 K27NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Gundersen Lutheran
1900 South AveLa CrosseWI54601Lab/Radiology985561
Arnold Nomann
E7332 Skyline DriveViroquaWI54655Anesthesia347052
Clinical Ultrasound Services
PO Box 7PostvilleIA52162Ultrasound222930
RPH on the go
PO Box 102640AtlantaGA303684640Pharmacist214644
Access CRNA Anesthesia Relief Services
N2685 Potato Ridge RoadLa CrosseWI54601Anesthesia207310
FieldValueIRS element (for citing)
Number Of Contractors GT100 K8NumberOfContractorsGT100K
All Other Contributions96235AllOtherContributions
Total Contributions96235TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Hospital6219904780844847808448
Clinic6211101012063610120636
Retail Pharmacy44611057082455708245
Home Health & hospice621610833663833663
Meals and Dietary72221020198610690195085
FieldValueIRS element (for citing)
Total Program Service Revenue64672978TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column384358TotalRevenueColumn
Exclusion$384,358ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column26TotalRevenueColumn
Exclusion$26ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real236480Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real236480Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column236480TotalRevenueColumn
Exclusion$236,480ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1276446Securities
Other287834Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1210561Securities
Other181485Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities65885Securities
Other106349Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column172234TotalRevenueColumn
Exclusion$172,234ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column65562311TotalRevenueColumn
Related Or Exempt Function Income58869648RelatedOrExemptFunctionIncome
Unrelated Business Revenue5803330UnrelatedBusinessRevenue
Exclusion$793,098ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total146238Total
Program Services146238ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total11000Total
Program Services11000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total794907Total
Management And General794907ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total22606275Total
Program Services20629189ProgramServices
Management And General1977086ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total901629Total
Program Services822775ProgramServices
Management And General78854ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5538039Total
Program Services5053697ProgramServices
Management And General484342ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1562370Total
Program Services1387393ProgramServices
Management And General174977ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total68149Total
Management And General68149ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total70550Total
Management And General70550ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4372926Total
Program Services3923995ProgramServices
Management And General448931ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total79763Total
Management And General79763ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total16746186Total
Program Services16114328ProgramServices
Management And General631858ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total195172Total
Management And General195172ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2546127Total
Program Services2546127ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total80513Total
Program Services63833ProgramServices
Management And General16680ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2471876Total
Program Services1780282ProgramServices
Management And General691594ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total252928Total
Management And General252928ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad debt expense18142271814227
Dues and Subscriptions370228212441157787
Miscellaneous1100824654263540

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total60739185Total
Program Services54552067ProgramServices
Management And General6187118ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1597572BOY
EOY1605297EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY10223366BOY
EOY11958786EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6194236BOY
EOY6681155EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2287407BOY
EOY2174541EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY174817BOY
EOY207820EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis56245757LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec21133733LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY34990566BOY
EOY35112024EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY7802990BOY
EOY8690342EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY12180BOY
EOY12180EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY2322485BOY
EOY2218284EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY682063BOY
EOY649257EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1688204BOY
EOY3086565EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY67975886BOY
EOY72396251EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6174037BOY
EOY5097957EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY24983680BOY
EOY24315848EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY26037BOY
EOY12830EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY549621BOY
EOY2122027EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY31733375BOY
EOY31548662EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY36149673BOY
EOY40730886EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY92838BOY
EOY116703EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY36242511BOY
EOY40847589EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY67975886BOY
EOY72396251EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$4,885OtherActivitiesAmount
Total Lobbying Expenditures IIB4885TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1i:Identifier
Return ReferenceExplanation of Other Lobbying Activities:ReturnReference
ExplanationVernon Memorial Healthcare, Inc. pays annual association memberships to the wisconsin hospital association and rural wisconsin health cooperative. These dues are primarily for access to educational materials and staff training and development. A small portion of the annual dues were used in conjuction with lobbying activities with the goal of improving the overall healthcare environment.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1176135OtherCostOrOtherBasis
Book Value1176135BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis41770403OtherCostOrOtherBasis
Depreciation12864860Depreciation
Book Value28905543BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis11791913OtherCostOrOtherBasis
Depreciation8268873Depreciation
Book Value3523040BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1507306OtherCostOrOtherBasis
Book Value1507306BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings35112024TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
deferred compensation plan liability - funded$1,174,953
Postretirement Benefit Obligation$302,160
Deferred compensation plan liability - unfunded$644,914
FieldValueIRS element (for citing)
Total Of Amounts2122027TotalOfAmounts
Total Revenue65562311TotalRevenue
Total Expenses60739185TotalExpenses
Excess Or Deficit For Year4823126ExcessOrDeficitForYear
Net Unrealized GL On Investments601233NetUnrealizedGLOnInvestments
Prior Period Adjustments-644914PriorPeriodAdjustments
Other-$174,367OtherAmount
Total Adjustments-218048TotalAdjustments
Excess Or Deficit Per FS4605078ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt65885524TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments601233NetUnrealizedGainsInvestments
Revenue Not Rptd F990601233RevenueNotRptdF990
Revenue Subtotal65284291RevenueSubtotal
Other Revenues Not Included278020OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt278020RevenueNotRptdOnFinStmt
Total Revenue Per Form99065562311TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt60629726TotExpensesEtcAuditedFinclStmt
Other Expenses Included168561OtherExpensesIncluded
Expenses Not Rptd F990168561ExpensesNotRptdF990
Expenses Subtotal60461165ExpensesSubtotal
Other Expenses Not Included278020OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt278020ExpensesNotRptdOnFinStmt
Total Expenses Per Form99060739185TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part X:Description of Uncertain Tax Positions Under FIN 48:INCOME TAXES THE ORGANIZATION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION IS ALSO EXEMPT FROM STATE INCOME TAXES, PURSUANT TO SIMILAR STATE OF WISCONSIN TAX LAWS. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ORGANIZATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION IS ALSO ENGAGED, TO A LIMITED EXTENT, IN ACTIVITIES WHICH THE INTERNAL REVENUE SERVICE CONSIDERS UNRELATED TO THE ORGANIZATION'S EXEMPT PURPOSE AND, THEREFORE, TAXABLE. THESE ACTIVITIES, HOWEVER, ANNUALLY RESULT IN NET OPERATING LOSSES FOR INCOME TAX PURPOSES. THE ORGANIZATION DOES NOT PRESENTLY ANTICIPATE THAT A TAX BENEFIT FROM THESE NET OPERATING LOSSES WILL BE REALIZED IN THE FUTURE. ACCORDINGLY, ANY POTENTIAL DEFERRED TAX ASSET RESULTING FROM THE AVAILABILITY OF NET OPERATING LOSS CARRYFORWARDS IS OFFSET BY A VALUATION ALLOWANCE OF EQUAL AMOUNT. NO DEFERRED TAX ASSETS AND LIABILITIES HAVE BEEN RECOGNIZED SINCE NO OTHER DIFFERENCES EXIST BETWEEN THE FINANCIAL AND TAX BASES OF REPORTING THE ORGANIZATION'S ASSETS AND LIABILITIES. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES FOR UNRECOGNIZED TAX BENEFITS FROM UNCERTAIN TAX POSITIONS IN 2010 OR 2009. FEDERAL RETURNS FOR THE TAX YEARS 2006 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
Part XI, Line 8 - Other Adjustments:Net assets released from restriction for operations: -5806. Postretirement Benefit Obligation Adjustment: -168561.
Part XII, Line 4b - Other Adjustments:Expenses netted against revenue on the audited financials: 278020.
Part XIII, Line 2d - Other Adjustments:Postretirement Benefit Obligation Adjustment: 168561.
Part XIII, Line 4b - Other Adjustments:Expenses netted against revenue on the audited financials: 278020.
PART XI, LINE 7 DURING 2010, MANAGEMENT DETERMINED THAT THE DEFERRED COMPENSATION PLAN ASSETS AND RELATED OTHER LONG-TERM LIABILITIES WAS UNDERSTATED IN PRIOR YEARS. TOTAL ASSETS AND TOTAL LIABILITIES WERE UNDERSTATED BY $310,826. IN ADDITION, MANAGEMENT DETERMINED THAT THEY HAVE ANOTHER DEFERRED COMPENSATION PLAN ENTIRELY FUNDED BY THE ORGANIZATION. NET ASSETS AT OCTOBER 1, 2008, WERE UNDERSTATED BY $506,417 AND EMPLOYEE BENEFIT EXPENSE FOR 2009 WAS UNDERSTATED BY $138,497 RELATED TO THIS PLAN. MANAGEMENT CONCLUDED THAT THE FINANCIAL STATEMENTS SHOULD BE RESTATED TO REFLECT THE PROPER PRESENTATION OF THE DEFERRED COMPENSATION PLAN ASSETS, OTHER LONG-TERM LIABILITIES, AND EMPLOYEE BENEFITS EXPENSE. ACCORDINGLY, BEGINNING NET ASSETS DECREASED $506,417 AND REVENUE IN EXCESS OF EXPENSES FOR THE YEAR ENDED SEPTEMBER 30, 2009, DECREASED $138,497 FROM AMOUNTS PREVIOUSLY REPORTED. TOTAL ASSETS INCREASED $310,826 AND TOTAL LONG-TERM LIABILITIES INCREASED $955,740 AT SEPTEMBER 30, 2009.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage300.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense484602TotalCommunityBenefitExpense
Net Community Benefit Expense484602NetCommunityBenefitExpense
Percent Of Total Expense0.00830PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense6561557TotalCommunityBenefitExpense
Direct Offsetting Revenue3990062DirectOffsettingRevenue
Net Community Benefit Expense2571495NetCommunityBenefitExpense
Percent Of Total Expense0.04380PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense7046159TotalCommunityBenefitExpense
Direct Offsetting Revenue3990062DirectOffsettingRevenue
Net Community Benefit Expense3056097NetCommunityBenefitExpense
Percent Of Total Expense0.05210PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense61293TotalCommunityBenefitExpense
Direct Offsetting Revenue4740DirectOffsettingRevenue
Net Community Benefit Expense56553NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense178774TotalCommunityBenefitExpense
Net Community Benefit Expense178774NetCommunityBenefitExpense
Percent Of Total Expense0.00300PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense357137TotalCommunityBenefitExpense
Direct Offsetting Revenue7450DirectOffsettingRevenue
Net Community Benefit Expense349687NetCommunityBenefitExpense
Percent Of Total Expense0.00600PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense597204TotalCommunityBenefitExpense
Direct Offsetting Revenue12190DirectOffsettingRevenue
Net Community Benefit Expense585014NetCommunityBenefitExpense
Percent Of Total Expense0.01000PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense7643363TotalCommunityBenefitExpense
Direct Offsetting Revenue4002252DirectOffsettingRevenue
Net Community Benefit Expense3641111NetCommunityBenefitExpense
Percent Of Total Expense0.06210PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense2762TotalCommunityBuildingExpense
Net Community Building Expense2762NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense2762TotalCommunityBuildingExpense
Net Community Building Expense2762NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$1,023,559BadDebtExpenseAmount
Amount Attributable To204710AmountAttributableTo
Amount Reimbursed By Medicare10289601AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare10440429CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-150828MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1Vernon Memorial Hospital IncBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1507 South Main StAddressLine1
CityViroquaCity
StateWIState
ZIP Code54665ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours
Other4 RURAL HEALTH CLINICSOther

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
General ExplanationPart I, Line 7: The calculated percent of total expenses excludes bad debt expense of $1,814,227. The expenses recognized in the table were calculated using the cost-to-charge ratio from the medicare cost report. These calculations from worksheet 2 were used to arrive at cost of charity care and unreimbursed Medicaid. The cost of community health improvement and health professionals education reflect the direct and indirect costs as determined by the hospital.Part III, Line 4: Accounts receivable and credit policy The cost-to-charge ratio was calculated using the Medicare cost report.Accounts receivable are uncollateralized patient obligations that are stated at the amount management expects to collect from outstanding balances. These obligations are primarily from local residents, most of whom are insured under third-party payer agreements. The Organization bills third-party payers on each patient's behalf, or if a patient is uninsured, the patient is billed directly. Once claims are settled with the primary payer, any secondary insurance is billed, and patients are billed for co pay and deductible amounts that are the patients' responsibility. Payments on accounts receivable are applied to the specific claim identified on the remittance advice or statement. The Organization does not have a policy to charge interest on past due accounts. The carrying amounts of accounts receivable are reduced by allowances that reflect management's best estimate of the amounts that will not be collected. Management provides for contractual adjustments under terms of third-party reimbursement agreements through charge to gross patient service revenue and a credit to the accounts receivable. In addition, management provides for probable uncollectible amounts, primarily uninsured patients and amounts patients are personally responsible for, through a charge to operations and a credit to a valuation allowance based on its assessment of historical collection likelihood and the current status of individual accounts. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to accounts receivable. Accounts receivable are recorded in the accompanying balance sheets net of contractual adjustments and allowance for doubtful accounts. Part III, Line 8: The shortfall should be treated as a community benefit expense because the hospital professionals offer classes to the community aimed at maintaining and improving the general health of the population. Also a significant portion of the people receiving services from the hospital are covered by either Medicare or Medical Assistance programs and are residents of the local community. The cost to charge ratio was calculated using the Medicare cost report.Part III, Line 9b: Patients receive our community care application when they present for services. They are encouraged to review the application and submit the required information to apply for potential coverage. If they have questions or need help with the application they may meet with our patient accounts staff. Once a patient applies and is approved for community care, the application is considered current and valid for the following 12-month period.Part VI, Line 2 : Vernon Memorial Healthcare's Community Health Education staff actively works with a variety of businesses in the service area to educate employees and assess needs for programs and services that we could assist with. VMH staff from many departments speak to community groups on a variety of health-related topics. Needs are informally assessed at these and other events sponsored by VMH. In 2011 VMH contracted with the United Way to participate in a formal Community Needs Assessment project that will be conducted in 2011 and 2012. Part VI, Line 3: Signs are posted at all registration locations informing patients of our Community Care Program. If patients inquire about the program, they are also provided with information about government programs that they may qualify for. Registration staff also inform patients with no insurance about community care or other programs that they may qualify for. Staff in the Patient Accounting Department are readily available to assist patients in completing the application form and to answer questions. Part VI, Line 4: Vernon Memorial Healthcare's primary service area is the area within approximately a 25-mile radius of Viroqua, WI. This is primarily a rural area with several small communities. The largest city in the service area is Viroqua, a town of approximately 4,500. The nearest hospitals are approximately 35 miles away in LaCrosse, Sparta, Richland Center, and Boscobel. Vernon Memorial Healthcare is located in Vernon County Wisconsin. In 2009, the average household income in Vernon County was $37,876, the unemployment rate was 7.9%, and 14% of the residents lived below the poverty guidelines.Part VI, Line 5: While there is a growing agreement in the United States about what constitutes a non-profit hospital's community benefit, this is a work in progress. Our hospital provides charity care and other community benefits as defined by the IRS. But in addition, we believe that we provide a critically important community benefit which is not quantified. Our hospital, like most rural hospitals, was created and is maintained in order to provide local access to many health services: birthing center, diagnostics, emergency services and urgent care, home care, hospice, infusion services, inpatient care, laboratory services, occupational health, rehabilitation services, specialty medicine, speech and audiology, surgical services, and womens health.Part VI, Line 6: All members of the organization's governing body reside in the service area and serve on a voluntary basis. None of the members are employees or contractors of the organization. Medical staff privileges are extended to all qualified physicians who apply. Vernon Memorial Healthcare is a non-profit organization, so all earnings in excess of cost are used by the organization to improve the healthcare of the people we serve through the purchase or upgrade of facilities and equipment, or the addition or expansion of needed services.Part VI, Line 8: List of states receiving community benefit report: WIGeneralExplanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
Viroqua Area Schools
115 N Education AveViroquaWI54665396004944501(c)(3)22442General Support
Youth Initiative High School
500 East Jefferson StViroquaWI54665391906073501(c)(3)12000General Support
Pleasant Ridge Waldorf School
431 E Court StViroquaWI54665391357578501(c)(3)10000General Support
Kickapoo Area School District
S6520 State Hwy 131ViolaWI54664396030294501(c)(3)8540General Support
Viroqua Area Foundation
PO Box 262ViroquaWI54665391603279501(c)(3)60500General Support
DRIFTLESS UNITED ATHLETICS UNITED
PO BOX 12VIRoquaWI54665800398975501(c)(3)8000GENERAL SUPPORT
NORSEMEN BOOSTER CLUB
206 WEST AVE SOUTHWESTBYWI54667392041425501(c)(3)11997GENERAL SUPPORT
WESTBY AREA SCHOOL DISTRICT
206 WEST AVE SOUTHWESTBYWI54667396005143501(c)(3)12759GENERAL SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants8TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantBENEFIT FUND CONTRIBUTIONsTypeOfGrant
Number Of Recipients1NumberOfRecipients
Amount Of Cash Grant11000AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: All donees are required to submit their donation requests to the CEO or marketing manager of Vernon Memorial Healthcare, Inc. Requests submitted to the marketing manager are forwarded to the CEO for final approval. The requests must include a detailed description of what the funds will be used for and how they will benefit the community. Donees are asked to provide confirmation of receipt and an explanation of how the funds were used, either verbally or in writing, to the CEO. If the requests are deemed beneficial to the needs of the community, the funds are awarded to the applying organization.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Garith Steiner
2568370110190165000165280114820312366000
Mary Koenig
16488507188015500010139088130206525000
Kyle Bakkum
17953706673000104060114820208098000
Dr Jeffrey menn
417750062940165000122080150680467820000
Dr Brian Woody
25459406937000120150150680288614000
Dr Duane Koons
24362106833000118420150680277364000
Dr Deborah Prior
218630082390130000139830115000265352000
Brian Miller
29869406293000102030126450327835000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental InformationIdentifier
Return ReferencePart IIIReturnReference
ExplanationPART III: IN ADDITION TO THE COMPENSATION REPORTED IN PART II, THE ORGANIZATION ACCRUED ADDITIONAL PAID LEAVE TIME THAT IS RECOGNIZED AS UNFUNDED DEFERRED COMPENSATION FOR THREE INDIVIDUALS. THE UNFUNDED DEFERRED COMPENSATION EXPENSED IN FISCAL YEAR 2010 WAS AS FOLLOWS: GARITH STEINER $66,335 MARY KOENIG $29,181 KYLE BAKKUM $24,980Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Wisconsin Health and Educational Facilities AuthorityBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN391337855IssuerEIN
CUSIP Number97710VXQ6CUSIPNumber
Date Issued2005-05-19DateIssued
Issue Price22894672IssuePrice
Description Of PurposeFinance construction of facility expansionDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds22894672TotalProceeds
Amount In Reserve Fund1846325AmountInReserveFund
Issuance Costs From Proceeds457893IssuanceCostsFromProceeds
Capital Expenditures20590454CapitalExpenditures
Year Of Subst Completion2006YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Counsel Routinely Engaged0BondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 6Any person who is eighteen years of age or older and a bona fide resident of Vernon County, Wisconsin, or the area within a radius of twenty-five miles of the City of Viroqua, Wisconsin, and who has the heretofore or may hereafter contribute ten dollars or more to the Corporation shall be a member thereof. All members of the Corporation shall be voting members. Each member shall have one vote on any matter submitted to a vote of the members of the Corporation.
Form 990, Part VI, Section A, line 7aThe duties of the members of the Vernon Memorial Healthcare, Inc ("the Corporation") shall be: the election of members of the Board of Directors of the Corporation, the removal of members of the Board of Directors of the Corporation, and the changing of the number of directors constituting the Board of Directors of the Corporation.
Form 990, Part VI, Section A, line 7bThe duties of the members of the Vernon Memorial Healthcare, Inc ("the Corporation") shall also include: the amendment, restatement, or modification of the Articles of Incorporation or Bylaws of the Corporation; and the approval of the sale, lease, or other disposition of all, or substantially all of the assets and property of the Corporation, the dissolution of the Corporation, or its merger with another corporation.
Form 990, Part VI, Section B, line 11The form 990 was reviewed and approved by a committee of the board of directors of Vernon Memorial Healthcare, Inc. before submission.
Form 990, Part VI, Section B, line 12All board members of Vernon Memorial Healthcare, Inc. are required to disclose all possible conflicts of interest when first elected to the board of directors. During their terms, if any business relationships are entered into which may affect their independence as a member, the member must immediately disclose these relationships.
Form 990, Part VI, Section B, line 15For upper management positions, Vernon Memorial Hospital, Inc. utilizes an independent consulting firm that provides survey results for similar positions across the country annually. The 'true market average' for each position is included in the information received. According to the contracts for the CEO, CFO and COO, these people are to receive the 'true market average' as defined in the study. Deviations from this are permitted if there is mutual consent. The CEO has the right to amend the amount for the CFO and COO. The Board has the right to amend the amount for the CEO. The Executive Committee of the Board reviews the data for the CEO annually to determine the amount of his compensation, and any changes in compensation are maintained in the personnel file. The CEO reviews the data for the CFO and COO annually to determine the amount of compensation and any changes are maintained in the personnel file.
Form 990, Part VI, Section C, line 19Vernon Memorial Healthcare, Inc. makes its financial statements and governing documents available to the public on a per request basis. The form 990 is also available to the public on a third party website called GuideStar.
Form 990, Part XI, Line 2cVernon Memorial Healthcare, Inc. does not have a specific committee which assumes the responsibility for oversight of the audit. The entire board of directors is responsible for selection of the independent accountant. No changes have been made in the past year regarding this oversight function of the governing body.Oversight of audit

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Vernon Memorial Healthcare Foundation IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1507 South Main StreetAddressLine1
CityViroquaCity
StateWIState
ZIP Code54665ZIPCode
FieldValueIRS element (for citing)
EIN391515716EIN
Primary ActivitiesFundraisingPrimaryActivities
Legal Domicile StateWILegalDomicileState
Exempt Code Section501(C)3ExemptCodeSection
Public Charity Status509(a)(3)PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line111 c - III - FIBusinessNameLine1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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