OCONTO HOSPITAL & MEDICAL CENTER INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- OCONTO HOSPITAL & MEDICAL CENTER INC (EIN 06-1745397)
- Tax period
- 2024-10-01 to 2025-09-30
- Filed
- 2026-08-14
- IRS object ID
- 202612269349301336
- Schema version
- 2024v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2026-08-14T10:18:54+00:00 | ReturnTs |
| Tax Period End | 2025-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 EAST RANDOLPH DRIVE SUITE 5500 | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606016436 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061745397 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OCONTO HOSPITAL AND MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OCON | BusinessNameControlTxt |
| Phone | 9208351100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 820 ARBUTUS AVENUE | AddressLine1Txt |
| City | OCONTO | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54153 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN CEELEN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2026-08-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ZELIJKO POPOVIC | PreparerPersonNm |
| PTIN | P01795951 | PTIN |
| Phone | 3126651000 | PhoneNum |
| Preparation | 2026-08-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BELLIN HEALTH OCONTO HOSPITAL | BusinessNameLine1Txt |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN CEELEN | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 820 ARBUTUS AVENUE | AddressLine1Txt |
| City | OCONTO | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54153 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $101,542,274 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BELLIN.ORG/LOCATIONS/BELLIN-HEALTH-OCONTO-HOSPITAL | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2005 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | OCONTO HOSPITAL & MEDICAL CENTER, INC. (THE ORGANIZATION) IS YOUR HOMETOWN HEALTHCARE SERVICE PROVIDER, CREATED TO MAKE OUTSTANDING HEALTHCARE CONVENIENT. BACKED BY THE RESOURCES OF BELLIN HEALTH, THE ORGANIZATION OFFERS OUTSTANDING HOSPITAL-BASED, EMERGENCY AND PRIMARY CARE SERVICES. THE ORGANIZATION OFFERS THE CARE YOU NEED WHERE YOU WANT IT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 414 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $218,199 | PYContributionsGrantsAmt |
| CY Contributions Grants | $25,846 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $90,621,783 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $98,766,763 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$17,000 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,251 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,307,863 | PYOtherRevenueAmt |
| CY Other Revenue | $2,678,405 | CYOtherRevenueAmt |
| PY Total Revenue | $93,130,845 | PYTotalRevenueAmt |
| CY Total Revenue | $101,474,265 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $44,733,660 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $46,027,178 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $43,928,867 | PYOtherExpensesAmt |
| CY Other Expenses | $48,469,107 | CYOtherExpensesAmt |
| PY Total Expenses | $88,662,527 | PYTotalExpensesAmt |
| CY Total Expenses | $94,496,285 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,468,318 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,977,980 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $50,170,743 | TotalAssetsBOYAmt |
| Total Assets EOY | $46,274,453 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $21,940,866 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,066,596 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $28,229,877 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $35,207,857 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF OCONTO HOSPITAL & MEDICAL CENTER IS TO PROVIDE 24-HOUR LOCAL ACCESS TO EFFECTIVE, EFFICIENT HEALTH, WELLNESS AND PREVENTATIVE SERVICES TO OCONTO AND THE SURROUNDING RURAL COMMUNITIES. TOWARD THIS PURPOSE OCONTO HOSPITAL & MEDICAL CENTER WORKS IN PARTNERSHIP WITH THE COMMUNITY, AND BELLIN HEALTH. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $60,119,065 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $71,938,375 | RevenueAmt |
| Desc | AS A KEY REGIONAL ASSET, THE ORGANIZATION IS A NOT-FOR-PROFIT HEALTHCARE PROVIDER. THE ORGANIZATION PROVIDES ACUTE HOSPITAL, EMERGENCY AND URGENT CARE TO RESIDENTS OF OCONTO, WISCONSIN, AND THE SURROUNDING COMMUNITIES. DURING THE PERIOD OF OCTOBER 1, 2024 TO SEPTEMBER 30, 2025, 367 INPATIENT DAYS WERE PROVIDED AND 1,321 SWING BED DAYS WERE PROVIDED. THE NUMBER OF OUTPATIENTS REGISTERED DURING THE SAME 12 MONTH PERIOD WAS 23,036. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $26,438,482 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $29,495,149 | RevenueAmt |
| Desc | OCONTO HOSPITAL AND MEDICAL CENTER OPERATES A 10-BED CRITICAL ACCESS HOSPITAL (CAH) WHICH PROVIDES BOTH INPATIENT AND OUTPATIENT MEDICAL AND SURGICAL SERVICES. THE OCONTO HOSPITAL & MEDICAL CENTER ALSO OPERATES A MULTISPECIALTY CLINIC IN MARINETTE WISCONSIN. SERVICES OFFERED AT THE MARINETTE LOCATION INCLUDE PRIMARY CARE SERVICES, RADIATION ONCOLOGY SERVICES, CHEMOTHERAPY, AND INFUSION SERVICES. IN ADDITION, THE ORGANIZATION HAS PRIMARY CARE CLINICS IN OCONTO, OCONTO FALLS, CRIVITZ, LAKEWOOD, SURING, AND PESHTIGO WISCONSIN, AND DAGGETT AND MENOMINEE MICHIGAN. THESE PROGRAM SERVICES PROVIDED 21,567 URGENT CARE VISITS, 88,208 PRIMARY CARE VISITS AND 39,057 SPECIALTY PROVIDER VISITS TO THESE COMMUNITIES DURING THE PERIOD OF OCTOBER 1, 2024 TO SEPTEMBER 30, 2025. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $86,557,547 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 414 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Policies Reference Chapters | false | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERIC JACOBSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9204457260 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2020 SOUTH WEBSTER AVENUE | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54301 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| CHRISTINE WOLESKE | |||||||||
| BOARD OF DIRECTORS, PRESIDENT | 2.0 | 46.0 | Yes (X) | Yes (X) | $0 | $1,888,539 | $201,133 | ||
| LAURA HIEB | |||||||||
| BOARD OF DIRECTORS, CHIEF NURSING OFFICER | 2.0 | 46.0 | Yes (X) | Yes (X) | $0 | $466,684 | $66,984 | ||
| PETER VANDENHOUTEN | |||||||||
| BOARD OF DIRECTORS, SECRETARY, SR VP LEGAL COUNSEL | 2.0 | 48.0 | Yes (X) | Yes (X) | $0 | $629,937 | $85,132 | ||
| SCOTT RATHGABER MD | |||||||||
| BOARD OF DIRECTORS, CEO | 2.0 | 48.0 | Yes (X) | Yes (X) | $0 | $1,324,275 | $73,275 | ||
| SHARLA BAENEN | |||||||||
| BOARD OF DIRECTORS, CHIEF OPERATING OFFICER | 2.0 | 46.0 | Yes (X) | Yes (X) | $0 | $653,831 | $93,519 | ||
| MICHAEL LANDRUM MD | |||||||||
| BOARD OF DIRECTORS, PHYSICIAN DIRECTOR | 2.0 | 46.0 | Yes (X) | $0 | $507,796 | $24,867 | |||
| DANIEL LILLY | |||||||||
| ASSISTANT SECRETARY, CHIEF LEGAL OFFICER | 2.0 | 48.0 | Yes (X) | $0 | $617,635 | $74,467 | |||
| JOHN CEELEN | |||||||||
| TREASURER, CHIEF FINANCIAL OFFICER | 1.0 | 49.0 | Yes (X) | $0 | $728,316 | $54,052 | |||
| JULIE BIEBER BULIN | |||||||||
| VP OCONTO HOSPITAL | 50.0 | 0 | Yes (X) | $184,922 | $0 | $24,833 | |||
| MICHELLE MICKA | |||||||||
| ASSISTANT TREASURER, VICE PRESIDENT, FINANCE & ACCOUNTING | 2.0 | 48.0 | Yes (X) | $0 | $379,411 | $72,275 | |||
| DAVID HOYER MD | |||||||||
| PHYSICIAN | 40.0 | 0 | $502,107 | $0 | $50,615 | Yes (X) | |||
| JASON COISMAN MD | |||||||||
| PHYSICIAN | 40.0 | 0 | $453,996 | $0 | $46,238 | Yes (X) | |||
| JON SIMMONS MD | |||||||||
| PHYSICIAN | 50.0 | 0 | $379,323 | $0 | $30,839 | Yes (X) | |||
| MICHAEL BRENNER MD | |||||||||
| PHYSICIAN | 50.0 | 0 | $366,130 | $0 | $51,372 | Yes (X) | |||
| PAWNEET SINGH | |||||||||
| PHYSICIAN | 50.0 | 0 | $551,948 | $0 | $29,215 | Yes (X) | |||
| STEVE LITTLE | |||||||||
| FORMER CHIEF FINANCIAL OFFICER | 0.0 | 0.0 | $0 | $209,856 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,438,426 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,406,280 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $978,816 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 62 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| RADIOLOGY ASSOCIATES OF APPLETON | |||||
| 2500 E CAPITAL DR | APPLETON | WI | 54911 | RADIATION ONCOLOGY PROVIDER SERVICES | $684,517 |
| 4M BUILDING SOLUTIONS LLC | |||||
| 2936 HOLMGREN WAY | GREEN BAY | WI | 54304 | HOUSEKEEPING SERVICES | $600,777 |
| BAY TOWEL LINEN & UNIFORM RENT | |||||
| 2580 S BROADWAY | GREENBAY | WI | 54304 | CONTRACTED LINEN SERVICES | $337,752 |
| UROLOGY ASSOC OF GREEN BAY SC | |||||
| 720 S VAN BURENT ST | GREEN BAY | WI | 54301 | PROFESSIONAL SURGICAL SERVICES | $276,000 |
| APOGEE MEDICAL MANAGEMENT | |||||
| 15059 N SCOTTSDALE RD STE 600 | SCOTTSDALE | AZ | 85254 | PROFESSIONAL SURGICAL SERVICES | $214,148 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $12,986 | RelatedOrganizationsAmt |
| Government Grants | $12,860 | GovernmentGrantsAmt |
| Total Contributions | $25,846 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621300 | $97,047,104 | $97,047,104 |
| CONTRACTED SERVICES | 621110 | $1,599,659 | $1,599,659 |
| RENT FROM AFFILIATES | 900099 | $120,000 | $120,000 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $98,766,763 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $24,592 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $17,261 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $7,331 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,331 | TotalRevenueColumnAmt |
| Exclusion | $7,331 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $53,999 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $50,748 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $3,251 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,251 | TotalRevenueColumnAmt |
| Exclusion | $3,251 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| INCENTIVE PAYMENTS | 621110 | $2,666,761 | $2,666,761 | |
| OTHER REVENUE | 900099 | $4,313 | $4,313 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,671,074 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $101,474,265 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $101,433,524 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $14,895 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,469,947 | TotalAmt |
| Program Services | $37,825,503 | ProgramServicesAmt |
| Management And General | $644,444 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,022,290 | TotalAmt |
| Program Services | $1,987,887 | ProgramServicesAmt |
| Management And General | $34,403 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,186,452 | TotalAmt |
| Program Services | $3,143,371 | ProgramServicesAmt |
| Management And General | $43,081 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,348,489 | TotalAmt |
| Program Services | $2,304,378 | ProgramServicesAmt |
| Management And General | $44,111 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,083,149 | TotalAmt |
| Program Services | $2,866,319 | ProgramServicesAmt |
| Management And General | $216,830 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297 | TotalAmt |
| Program Services | $297 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $360,284 | TotalAmt |
| Program Services | $295,500 | ProgramServicesAmt |
| Management And General | $64,784 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $222,738 | TotalAmt |
| Program Services | $215,882 | ProgramServicesAmt |
| Management And General | $6,856 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,072,553 | TotalAmt |
| Program Services | $3,980,653 | ProgramServicesAmt |
| Management And General | $91,900 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $548,249 | TotalAmt |
| Program Services | $531,296 | ProgramServicesAmt |
| Management And General | $16,953 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,294 | TotalAmt |
| Program Services | $92,133 | ProgramServicesAmt |
| Management And General | $3,161 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,874 | TotalAmt |
| Program Services | $156,790 | ProgramServicesAmt |
| Management And General | $108,084 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,526,539 | TotalAmt |
| Program Services | $3,473,968 | ProgramServicesAmt |
| Management And General | $52,571 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,541 | TotalAmt |
| Program Services | $12,456 | ProgramServicesAmt |
| Management And General | $39,085 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $30,664,499 | $24,361,567 | $6,302,932 |
| BAD DEBT EXPENSE | $2,910,303 | $2,910,303 | |
| FOOD | $2,057,821 | $2,057,752 | $69 |
| DUES & SUBSCRIPTIONS | $244,563 | $96,469 | $148,094 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $366,403 | TotalAmt |
| Program Services | $245,023 | ProgramServicesAmt |
| Management And General | $121,380 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,496,285 | TotalAmt |
| Program Services | $86,557,547 | ProgramServicesAmt |
| Management And General | $7,938,738 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,798,492 | BOYAmt |
| EOY | $2,554,072 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,490,853 | BOYAmt |
| EOY | $7,954,827 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,801,133 | BOYAmt |
| EOY | $1,618,531 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,789 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $63,189,145 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $40,378,141 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,455,242 | BOYAmt |
| EOY | $22,811,004 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,621,234 | BOYAmt |
| EOY | $11,336,019 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,170,743 | BOYAmt |
| EOY | $46,274,453 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,024,361 | BOYAmt |
| EOY | $4,483,429 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,511,442 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,405,063 | BOYAmt |
| EOY | $6,583,167 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,940,866 | BOYAmt |
| EOY | $11,066,596 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,395,386 | BOYAmt |
| EOY | $34,358,077 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $834,491 | BOYAmt |
| EOY | $849,780 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,229,877 | BOYAmt |
| EOY | $35,207,857 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,170,743 | BOYAmt |
| EOY | $46,274,453 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $6,977,980 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $682,918 | OtherCostOrOtherBasisAmt |
| Book Value | $682,918 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,770,104 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,965,115 | DepreciationAmt |
| Book Value | $15,804,989 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $33,650,005 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,413,026 | DepreciationAmt |
| Book Value | $6,236,979 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $86,118 | OtherCostOrOtherBasisAmt |
| Book Value | $86,118 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $22,811,004 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTEREST IN FOUNDATION | $849,780 |
| RIGHT OF USE ASSETS | $2,104,299 |
| DUE FROM THIRD-PARTY REIMBURSEMENT PROGRAMS | $6,844,435 |
| DUE FROM AFFILIATES | $1,537,505 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $11,336,019 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| FEDERAL INCOME TAXES | |
| DUE TO THIRD-PARTY REIMBURSEMENT PROGRAMS | $856,566 |
| OPERATING LEASE LIAIBILITIES | $2,104,299 |
| FINANCE LEASE LIABILITIES | $3,622,302 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,583,167 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Other Revenue | $0 | OtherRevenueAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $0 | RevenueSubtotalAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $0 | TotalRevenuePerForm990Amt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $0 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $0 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE | FormAndLineReferenceDesc |
| Explanation | THE SYSTEM AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, AND HAVE BEEN FULLY RESERVED. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $461,689 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $461,689 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00504 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,064,252 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,077,194 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,987,058 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02170 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $9,525,941 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,077,194 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,448,747 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02674 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,650 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $21,650 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00024 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,611 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,611 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00004 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $25,261 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,261 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00028 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $9,551,202 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,077,194 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,474,008 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02701 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 4 | PersonsServedCnt |
| Total Community Benefit Expns | $1,289 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,289 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00001 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 4 | PersonsServedCnt |
| Total Community Benefit Expns | $1,289 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,289 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00001 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,064,333 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,900,801 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,552,046 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,348,755 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OCONTO HOSPITAL & MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 820 ARBUTUS AVE | AddressLine1Txt |
| City | OCONTO | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54153 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://BELLIN.ORG/LOCATIONS/BELLIN | WebsiteAddressTxt |
| State License | 1061 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OCONTO HOSPITAL & MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 24 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://bellin.org/about-bellin-health/community-health-initiatives | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 24 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://bellin.org/about-bellin-health/community-health-initiatives | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://BELLIN.ORG/PATIENTS-VISITORS/BILLING-INSURANCE-SERVICES/FINANCIAL-ASSISTANCE-OPTIONS | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://BELLIN.ORG/PATIENTS-VISITORS/BILLING-INSURANCE-SERVICES/FINANCIAL-ASSISTANCE-OPTIONS | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://BELLIN.ORG/PATIENTS-VISITORS/BILLING-INSURANCE-SERVICES/FINANCIAL-ASSISTANCE-OPTIONS | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 FACILITY , 1 | FACILITY , 1 - OCONTO HOSPITAL & MEDICAL CENTER, INC.. THIS ASSESSMENT WAS BUILT ON COLLABORATION, ACTIVELY SEEKING INPUT FROM A BROAD CROSS SECTION OF COMMUNITY STAKEHOLDERS WITH THE GOAL OF REACHING CONSENSUS ON PRIORITIES TO MUTUALLY FOCUS HUMAN, MATERIAL AND FINANCIAL RESOURCES. BELOW IS A LISTING OF PARTICIPANTS IN A CHNA SUMMIT IN WHICH HEALTH PRIORITIES WERE DETERMINED: HEALTHY OCONTO COUNTY MEMBERS: - JODY ANDERSON, BELLIN HEALTH - JULIE BIEBER, BELLIN HEALTH OCONTO HOSPITAL - ELORA BLUM, OCONTO COUNTY PUBLIC HEALTH - STEFFANIE BISHOP, NORTHLAKES COMMUNITY CLINIC - DAVE HONISH, CESA 8 - DEBRA KONITZER, OCONTO COUNTY PUBLIC HEALTH - CHRISTOPHER BRABANT, HSHS - KEVIN MALNOR, TRI-COUNTY UNITED WAY - SCOTT SHACKELFORD, OCONTO COUNTY HEALTH & HUMAN SERVICES - JAELYN SCANLAN, OCONTO COUNTY PUBLIC HEALTH - SHERIFF TODD SKARBAN, OCONTO COUNTY - STAKEHOLDERS, PARTICIPANTS, AND PARTNERS: - SARA APPLEBEE, OCONTO COUNTY PUBLIC HEALTH - TOM BITTERS, OCONTO COUNTY HEALTH & HUMAN SERVICES BOARD - HEATHER BLUM, OCONTO COUNTY PUBLIC HEALTH - RON CHRISTENSEN, OCONTO COUNTY VETERANS SERVICES - AIMEE CLOUGH, OCONTO NON-PROFIT CHILDCARE - LISA DOLAN, UNITY RECOVERY SERVICES - AMANDA DORNFELD, UNIVERSITY OF WISCONSIN EXTENSION - BETH EARLEY, OCONTO COUNTY PUBLIC HEALTH - MELISSA FRANKEN, ENCOMPASS CHILDCARE - SUE HOFFMAN, OCONTO NON-PROFIT CHILDCARE - JESSICA HONISH, RAINBOW HOUSE - GABRIELLE LENTZ, WISCONSIN DEPARTMENT OF HEALTH SERVICES - AMY LONGSINE, OCONTO COUNTY PUBLIC HEALTH - EMILY MILLER, OCONTO UNIFIED SCHOOL DISTRICT - KARI OLSEN, GREATER GREEN BAY COMMUNITY FOUNDATION - TRACY ONDIK, EMERGENCY MEDICAL SERVICES - ERIK PRITZL, OCONTO COUNTY - BRENDA REHBERG, BELLIN HEALTH - ERIKA RITCHIE, GREATER GREEN BAY COMMUNITY FOUNDATION - FRANK SCHERSING, OCONTO COUNTY COMMISSION ON AGING - SARA SCHINDEL, UNIVERSITY OF WISCONSIN EXTENSION - TODD VANDER GALIEN, UNITY RECOVERY SERVICES - MARY WOEPSE, AGING AND DISABILITY RESOURCE CENTER |
| SCHEDULE H, PART V, SECTION B, LINE 6A FACILITY , 1 | FACILITY , 1 - OCONTO HOSPITAL & MEDICAL CENTER, INC.. HSHS ST. CLARE MEMORIAL HOSPITAL |
| SCHEDULE H, PART V, SECTION B, LINE 6B FACILITY , 1 | FACILITY , 1 - OCONTO HOSPITAL & MEDICAL CENTER, INC.. CESA 8 - HSHS ST. CLARE MEMORIAL HOSPITAL - OCONTO COUNTY ECONOMIC DEVELOPMENT CORPORATION - OCONTO COUNTY PUBLIC HEALTH - OCONTO COUNTY LAW ENFORCEMENT - OCONTO COUNTY VETERAN SERVICES - NORTHLAKES COMMUNITY CLINICS - TRI-COUNTY UNITED WAY |
| SCHEDULE H, PART V, SECTION B, LINE 11 FACILITY , 1 | FACILITY , 1 - OCONTO HOSPITAL & MEDICAL CENTER, INC.:. THE MOST RECENT CHNA IDENTIFIED COMMUNITY NEEDS FOR FISCAL YEARS 2023 THROUGH 2026. THE NEEDS IDENTIFIED ARE: MENTAL HEALTH, ALCOHOL AND OTHER DRUG ABUSE (AODA) AND TRANSPORTATION. A SUMMARY OF HOW THE HOSPITAL HAS BEEN ADDRESSING SOME OF THE NEEDS IDENTIFIED IN THE CHNA IS AS FOLLOWS: 1. MENTAL HEALTH - ANNUAL MEN'S EVENT - BELLIN OCONTO FITNESS HER/HIS PROGRAM - BELLIN OCONTO KIDS TRIATHLON - NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) - INCREASE RESOURCES AVAILABLE THROUGH FIND HELP 2. ALCOHOL AND OTHER DRUG ABUSE - DRUG TAKE BACK EVENTS - PARTNERING WITH THE TAVERN LEAGUE - DISTRIBUTED COASTERS AT TAVERN LEAGUE TO BE USED AT THE TAVERNS AND CONNECTED INDIVIDUALS WITH 988 - COMMUNITY FORUM ON FENTANYL AND DISTRIBUTED LOCK BOXES 3. TRANSPORTATION - PARTNERED WITH MENOMINEE REGIONAL TRANSIT TO A RURAL ROUTE IN OCONTO COUNTY - EDUCATED ONE ELECTED OFFICIAL ON THE NEED FOR TRANSPORTATION IN OUR RURAL AREA - CREATED A SUBCOMMITTEE TO IDENTIFY GAPS IN THE CITY OF OCONTO |
| SCHEDULE H, PART V, SECTION B, LINE 13 FACILITY , 1 | FACILITY , 1 - OCONTO HOSPITAL & MEDICAL CENTER, INC.. PRESUMPTIVE ELIGIBILITY INCLUDES FACTORS AS: HOMELESS, DECEASED WITH NO KNOWN ESTATE, APPROVED COURT BANKRUPTCY, PAYMENT ASSISTANCE RANK ORDER SCORE, ELIGIBLE FOR STATE OF WI FOOD SHARE PROGRAM. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 9 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| BELLIN HEALTH MARINETTE | ||||
| 2820 ROOSEVELT ROAD | MARINETTE | WI | 54143 | RURAL HEALTH CLINIC, ASC |
| BELLIN HEALTH OCONTO FALLS | ||||
| 107 E HIGHLAND DRIVE | OCONTO FALLS | WI | 54154 | RURAL HEALTH CLINIC |
| BELLIN HEALTH CRIVITZ | ||||
| 218 S US HWY 141 SUITE 100 | CRIVITZ | WI | 54114 | RURAL HEALTH CLINIC |
| BELLIN HEALTH OCONTO | ||||
| 820 ARBUTUS AVE SUITE 102 | OCONTO | WI | 54153 | RURAL HEALTH CLINIC |
| BELLIN HEALTH PESHTIGO | ||||
| 441 FRENCH STREET | PESHTIGO | WI | 54162 | RURAL HEALTH CLINIC |
| BELLIN HEALTH SURING | ||||
| 307 MANOR DRIVE | SURING | WI | 54174 | RURAL HEALTH CLINIC |
| BELLIN HEALTH DAGGETT | ||||
| 106 S SCHOOL ROAD | DAGGETT | MI | 49821 | RURAL HEALTH CLINIC |
| BELLIN HEALTH LAKEWOOD | ||||
| 15481 COMMERCIAL ROAD SUITE E | LAKEWOOD | WI | 54138 | RURAL HEALTH CLINIC |
| BELLIN HEALTH MENOMINEE | ||||
| 1100 10TH STREET | MENOMINEE | MI | 49858 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 6A COMMUNITY BENEFIT REPORT PREPARED BY RELATED ORGANIZATION | BELLIN HEALTH SYSTEMS, INC. |
| SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED TO CALCULATE FINANCIAL ASSISTANCE | AMOUNTS ARE CALCULATED BASED ON THE COST TO CHARGE RATIOS AND AMOUNTS PER THE FINANCIAL STATEMENTS |
| SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES | EARTH DAY CLEAN UP - REMOVED GARBAGE FROM 1 MILE STRIP ON ROOSEVELT RD MARINETTE COUNTY - PROVIDED COMMUNITY EDUCATION ON SUICIDE PREVENTION AT CITY OF OCONTO NATIONAL NIGHT OUT - DELIVERED OF MEALS 1X MONTH TO THE HOMEBOUND BY OCONTO LEADERSHIP FOR OCONTO COUNTY COMMISSION ON AGING - OCONTO LEADERSHIP VOLUNTEERING AT OCONTO COUNTY VETERANS SERVICE |
| SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE AMOUNT | THE BAD DEBT EXPENSE AT COST IS CALCULATED BASED ON THE COST TO CHARGE RATIOS. |
| SCHEDULE H, PART III, LINE 3 BAD DEBT EXPENSE METHODOLOGY | THE HOSPITAL UTILIZED HFMA #15, THEREFORE NONE OF THE BAD DEBT WOULD BE DEEMED CHARITY CARE |
| SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTE | THE ATTACHED FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC BAD DEBT EXPENSE FOOTNOTE. HOWEVER, THE SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES DESCRIBES THE HOSPITAL'S POLICY ON PAGE 9 OF THE FINANCIAL STATEMENTS. CONSISTENT WITH BELLIN HEALTH SYSTEMS' MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, BELLIN HEALTH SYSTEMS HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES (FOR EXAMPLE, COPAYS AND DEDUCTIBLES). THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS BELLIN HEALTH SYSTEMS EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. BELLIN HEALTH SYSTEMS' POLICY IS TO PROVIDE A 35% DISCOUNT FROM ESTABLISHED CHARGES TO UNINSURED PATIENTS. THIS POLICY DID NOT CHANGE IN 2024 AND 2025. |
| SCHEDULE H, PART III, LINE 8 COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTS | THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT FOR THE FOLLOWING REASONS. IRS REV RULE 69-545 WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. IN ADDITION, ELDERLY PATIENTS ARE OFTEN UNDERSERVED AND EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT EXEMPT HOSPITALS, CMS WOULD NEED TO PROVIDE THESE SERVICES. |
| SCHEDULE H, PART III, LINE 9B COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE | FOR PATIENTS WHO CANNOT MEET THE EXPECTATIONS OF THE DEBT COLLECTION POLICY, THE ORGANIZATION OFFERS FINANCIAL ASSISTANCE. THE ORGANIZATION WILL NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS BEFORE DETERMINING WHETHER A GUARANTOR IS ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. ALL PATIENTS ARE OFFERED A PLAIN LANGUAGE SUMMARY EXPLAINING THE FINANCIAL ASSISTANCE PROGRAM AS PART OF THE REGISTRATION PROCESS IN ADDITION, ALL STATEMENTS INCLUDE INFORMATION REGARDING FINANCIAL ASSISTANCE AVAILABILITY. |
| SCHEDULE H, PART V, SECTION B, LINE 16A FAP WEBSITE | - OCONTO HOSPITAL & MEDICAL CENTER, INC.: LINE 16A URL: HTTPS://BELLIN.ORG/PATIENTS-VISITORS/BILLING-INSURANCE-SERVICES/FINANCIAL-ASSISTANCE-OPTIONS; |
| SCHEDULE H, PART V, SECTION B, LINE 16B FAP APPLICATION WEBSITE | - OCONTO HOSPITAL & MEDICAL CENTER, INC.: LINE 16B URL: HTTPS://BELLIN.ORG/PATIENTS-VISITORS/BILLING-INSURANCE-SERVICES/FINANCIAL-ASSISTANCE-OPTIONS; |
| SCHEDULE H, PART V, SECTION B, LINE 16C FAP PLAIN LANGUAGE SUMMARY WEBSITE | - OCONTO HOSPITAL & MEDICAL CENTER, INC.: LINE 16C URL: HTTPS://BELLIN.ORG/PATIENTS-VISITORS/BILLING-INSURANCE-SERVICES/FINANCIAL-ASSISTANCE-OPTIONS; |
| SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT | BELLIN HEALTH OCONTO HOSPITAL (BHOH) CREATES TRUSTED RELATIONSHIPS BY LISTENING WITH INTENT, COMMUNICATING CLEARLY, AND VIEWING ALL WE DO THROUGH THE EYES OF THE PEOPLE WE SERVE. OUR SERVICES WILL BE EASY TO ACCESS AND EASY TO NAVIGATE. OUR PRICES AND OUTCOMES WILL BE READILY AVAILABLE AND EASY TO UNDERSTAND. WE DELIVER THE BELLIN PROMISE TO ALL "I WILL KNOW YOU. I WILL SHOW YOU RESPECT. I WILL GO WITH YOU ON YOUR JOURNEY. I AM HERE TO HELP YOU." BHOH AIMS TO INCREASE YEARS OF QUALITY LIFE BY PROVIDING THE HIGHEST QUALITY, RELIABLE CARE THAT IS INNOVATIVE, EQUITABLE, COORDINATED, AND AFFORDABLE FOR EVERYONE. THROUGH COLLABORATIVE RELATIONSHIPS, WE WILL ADDRESS THE SOCIAL DETERMINANTS OF HEALTH TO POSITIVELY IMPACT THE HEALTH AND WELL-BEING OF OUR PATIENTS AND COMMUNITIES. BHOH CONTINUES TO GROW RELATIONSHIPS WITH INDIVIDUALS, EMPLOYERS, SCHOOLS, AND COMMUNITIES TO INCREASE THE NUMBER OF PEOPLE WHO CHOOSE BELLIN HEALTH AS THEIR HEALTHCARE PARTNER. OUR PARTNERSHIPS, STEWARDSHIP AND POSITIVE FINANCIAL PERFORMANCE WILL DRIVE BETTER HEALTH, BETTER COMMUNITIES, AND LOWER TOTAL COST OF CARE. TOGETHER, WE WILL DESIGN SERVICES AND SUPPORT POLICIES THAT SOCIALLY, ECONOMICALLY, AND ENVIRONMENTALLY SHAPE A BETTER FUTURE." |
| SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | THE NO SURPRISE BILLING ACT WENT INTO EFFECT ON JANUARY 1, 2022. THE ACT REQUIRES HEALTHCARE PROVIDERS TO PROVIDE NOTICE OF THE ACT TO ALL PATIENTS, NOTIFY, PATIENTS IF THEIR INSURANCE IS OUT-OF-NETWORK AND OBTAIN CONSENT TO BALANCE BILL, AS WELL AS PROVIDE AN ESTIMATE OF CHARGES TO UNINSURED PATIENTS. |
| SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION | OCONTO COUNTY MARKET IS DEFINED BY THE BORDER OF BROWN AND MARINETTE COUNTY. - THE POPULATION IS JUST OVER 37,863, OF WHICH 11,106 HAVE A PRIMARY CARE PROVIDER ALIGNMENT WITH BELLIN HEALTH. - OCONTO COUNTY FALLS IN THE NATIONAL AVERAGE FOR DEPRIVATION SITTING AT 98%. THE COUNTY HAS TWO SPECIFIC AREAS; ONE THAT CIRCLES AROUND OCONTO AND THEN ANOTHER THAT STARTS NORTHWEST OF SURING AND CONTINUES TO THE LAKEWOOD AREA. BROADBAND ACCESS FOLLOWS THE PATTERN AS WELL. - BELLIN HEALTH OCONTO HOSPITAL (BHOH) IS ONE OF THE MAJOR PLAYERS IN THIS MARKET. NORTHLAKES COMMUNITY CLINIC IS LOCATED IN LAKEWOOD AND THEIR DENTAL PRACTICE IS HOUSED ON BHOH CAMPUS. - 20% OF OCONTO COUNTY ARE SENIORS OVER AGE 65. - 21% OF OUR COMMUNITY IS 18 AND YOUNGER. - OVER 55% OF OCONTO COUNTY HAS MEDICARE OR MEDICAID -16% OF PEOPLE IN OCONTO COUNTY ARE LOW INCOME |
| SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH | THE ORGANIZATION IS A STEERING TEAM MEMBER OF THE HEALTHY OCONTO COUNTY IMPROVEMENT WORK ALONG WITH HSHS ST. CLARE HOSPITAL, NORTHLAKES COMMUNITY CLINIC, AND OCONTO COUNTY PUBLIC HEALTH. THE ORGANIZATION HAS A 24/7 EMERGENCY ROOM AVAILABILITY TO THE COMMUNITY. |
| SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM | THE ORGANIZATION, IN PARTNERSHIP WITH BELLIN HEALTH SYSTEMS, INC., CONTINUES TO SERVE ITS COMMUNITY. |
| SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT | WI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SHARLA BAENEN | ||||||||||||||
| BOARD OF DIRECTORS, CHIEF OPERATING OFFICER | $0 | $406,815 | $0 | $203,988 | $0 | $43,028 | $0 | $65,300 | $0 | $28,219 | $0 | $747,350 | $0 | $40,237 |
| LAURA HIEB | ||||||||||||||
| BOARD OF DIRECTORS, CHIEF NURSING OFFICER | $0 | $314,619 | $0 | $115,915 | $0 | $36,150 | $0 | $43,792 | $0 | $23,192 | $0 | $533,668 | $0 | $32,940 |
| SCOTT RATHGABER MD | ||||||||||||||
| BOARD OF DIRECTORS, CEO | $0 | $1,278,368 | $0 | $0 | $0 | $45,907 | $0 | $48,300 | $0 | $24,975 | $0 | $1,397,550 | $0 | $0 |
| PETER VANDENHOUTEN | ||||||||||||||
| BOARD OF DIRECTORS, SECRETARY, SR VP LEGAL COUNSEL | $0 | $407,252 | $0 | $182,656 | $0 | $40,029 | $0 | $69,350 | $0 | $15,782 | $0 | $715,069 | $0 | $39,255 |
| CHRISTINE WOLESKE | ||||||||||||||
| BOARD OF DIRECTORS, PRESIDENT | $0 | $947,182 | $0 | $728,601 | $0 | $212,756 | $0 | $185,351 | $0 | $15,782 | $0 | $2,089,672 | $0 | $201,125 |
| MICHAEL LANDRUM MD | ||||||||||||||
| BOARD OF DIRECTORS, PHYSICIAN DIRECTOR | $0 | $439,467 | $0 | $67,915 | $0 | $414 | $0 | $21,893 | $0 | $2,974 | $0 | $532,663 | $0 | $0 |
| STEVE LITTLE | ||||||||||||||
| FORMER CHIEF FINANCIAL OFFICER | $0 | $209,856 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $209,856 | $0 | $0 |
| JOHN CEELEN | ||||||||||||||
| TREASURER, CHIEF FINANCIAL OFFICER | $0 | $598,104 | $0 | $129,468 | $0 | $744 | $0 | $29,147 | $0 | $24,905 | $0 | $782,368 | $0 | $0 |
| DANIEL LILLY | ||||||||||||||
| ASSISTANT SECRETARY, CHIEF LEGAL OFFICER | $0 | $514,649 | $0 | $97,000 | $0 | $5,986 | $0 | $48,300 | $0 | $26,167 | $0 | $692,102 | $0 | $0 |
| MICHELLE MICKA | ||||||||||||||
| ASSISTANT TREASURER, VICE PRESIDENT, FINANCE & ACCOUNTING | $0 | $374,568 | $0 | $0 | $0 | $4,843 | $0 | $48,300 | $0 | $23,975 | $0 | $451,686 | $0 | $0 |
| JULIE BIEBER BULIN | ||||||||||||||
| VP OCONTO HOSPITAL | $156,374 | $0 | $20,803 | $0 | $7,745 | $0 | $11,345 | $0 | $13,488 | $0 | $209,755 | $0 | $0 | $0 |
| MICHAEL BRENNER MD | ||||||||||||||
| PHYSICIAN | $335,428 | $0 | $30,435 | $0 | $267 | $0 | $20,222 | $0 | $31,150 | $0 | $417,502 | $0 | $0 | $0 |
| JASON COISMAN MD | ||||||||||||||
| PHYSICIAN | $453,582 | $0 | $0 | $0 | $414 | $0 | $20,357 | $0 | $25,881 | $0 | $500,234 | $0 | $0 | $0 |
| DAVID HOYER MD | ||||||||||||||
| PHYSICIAN | $501,693 | $0 | $0 | $0 | $414 | $0 | $22,370 | $0 | $28,245 | $0 | $552,722 | $0 | $0 | $0 |
| JON SIMMONS MD | ||||||||||||||
| PHYSICIAN | $214,412 | $0 | $164,137 | $0 | $774 | $0 | $18,647 | $0 | $12,192 | $0 | $410,162 | $0 | $0 | $0 |
| PAWNEET SINGH | ||||||||||||||
| PHYSICIAN | $390,396 | $0 | $161,372 | $0 | $180 | $0 | $17,082 | $0 | $12,133 | $0 | $581,163 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN | CERTAIN INDIVIDUALS LISTED IN SCHEDULE J, PART II PARTICIPATE IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO WHICH THE ORGANIZATION MAKES ANNUAL CONTRIBUTIONS. THESE CONTRIBUTIONS ARE AT RISK AND DO NOT BECOME VESTED AND PAYABLE UNLESS AND UNTIL THE INDIVIDUAL SATISFIES A SUBSTANTIAL FUTURE SERVICE REQUIREMENT. THE FOLLOWING INDIVIDUALS HAD CONTRIBUTIONS MADE TO THE PLAN FOR CALENDAR YEAR 2024: CHRISTINE WOLESKE SHARLA BAENEN PETER VANDENHOUTEN LAURA HEIB JOHN CEELEN LISA HARTON BELLIN MEMORIAL HOSPITAL, A RELATED PARTY, HAS A DEFERRED COMPENSATION PLAN FOR SELECTED EXECUTIVES. CHRISTINE WOLESKE,SHARLA BAENEN, PETER VANDENHOUTEN, AND LAURA HIEB PARTICIPATED IN THE 457(F) PLAN. THE FOLLOWING INDIVIDUAL, LISTED ON PART VII OF FORM 990, HAD THE FOLLOWING AMOUNTS DISTRIBUTED DURING CALENDAR YEAR 2024: CHRISTINE WOLESKE $201,125 SHARLA BAENEN $40,237 PETER VANDENHOUTEN $39,255 LAURA HIEB $32,940 |
| SCHEDULE J, PART I, LINE 3 | ALL PERSONNEL SERVICES ARE PERFORMED BY EMPLOYEES OF GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, LINE 15A | COMPENSATION IS DETERMINED BY A RELATED ORGANIZATION. COMPENSATION FOR THE CEO AND KEY EXECUTIVES ARE SET BY THE EXECUTIVE COMMITTEE OF THE BOARD SUPPORTED BY MARKET DATA FROM SURVEYS AND AN INDEPENDENT CONSULTANTS REPORT. THE COMPENSATION IS DETERMINED BY MEMBERS OF THE EXECUTIVE COMMITTEE WITHOUT CONFLICT AND IS DOCUMENTED. |
| FORM 990, PART VI, LINE 15B | SENIOR LEADERS: COMPENSATION IS DETERMINED BY A RELATED ORGANIZATION. COMPENSATION FOR THOSE WHO REPORT TO THE CEO IS TAKEN TO THE EXECUTIVE COMMITTEE FOR DISCUSSION/APPROVAL. |
| FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS | THE ORGANIZATION IS WHOLLY OWNED BY BELLIN MEMORIAL HOSPITAL, INC. |
| FORM 990, PART VI, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY | THE CORPORATE MEMBER, BELLIN HEALTH SYSTEMS, INC. HAS THE POWER TO APPOINT AND REMOVE BOARD MEMBERS. |
| FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS | THE CORPORATE MEMBER, BELLIN HEALTH SYSTEMS, INC., HAS THE POWER TO APPROVE MAJOR EXPENDITURES AND LONG-TERM BORROWINGS. |
| FORM 990, PART VI, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY | THE FORM 990 IS REVIEWED BY THE ACCOUNTING MANAGER AND PRINCIPAL OFFICER. IT WILL BE MADE AVAILABLE FOR ALL BOARD MEMBERS BEFORE FILING. |
| FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY | GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. (GLAS) ANNUALLY REQUIRES EXECUTIVE LEADERSHIP (VICE PRESIDENTS AND ABOVE), BOARD MEMBERS, MEDICAL GOVERNORS AND FOUNDATION BOARD MEMBERS TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED DISCLOSURE STATEMENTS ARE REVIEWED BY A CONFLICT OF INTEREST REVIEW PANEL WHICH INCLUDES REPRESENTATIVES FROM LEGAL, COMPLIANCE, MEDICAL LEADERSHIP, HUMAN RESOURCES AND SUPPLY CHAIN. INDIVIDUALS REPORTING A POTENTIAL CONFLICT OF INTEREST ARE SENT A RESOLUTION THANKING THEM FOR THEIR SERVICE TO THE ORGANIZATION, ADVISING THEM OF ANY RESTRICTIONS RELATED TO THEIR CONFLICT (I.E. INDIVIDUALS WITH A RELATIONSHIP TO ANOTHER ORGANIZATION ARE ADVISED THAT THEY MUST ABSTAIN FROM DECISION MAKING THAT WOULD DIRECTLY AND SOLELY IMPACT GLAS) AND REMINDING THEM OF THEIR CONFIDENTIALITY OBLIGATIONS WITH RESPECT TO GLAS' HEALTHCARE, EMPLOYMENT AND PROPRIETARY INFORMATION. |
| FORM 990, PART VI, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC | THE ORGANIZATION CONSIDERS THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS PROPERTY OF THE ORGANIZATION AND, THEREFORE, ARE NOT AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XII, LINE 2C CHANGE OF OVERSIGHT PROCESS OR SELECTION PROCESS | THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED AUDIT OF BELLIN HEALTH SYSTEMS, INC. THE BOARD OF DIRECTORS OF BELLIN HEALTH SYSTEMS, INC. ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT AUDITOR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| BELLIN GUNDERSEN HEALTH SYSTEM INC | ||||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54601 | 920504278 | SUPPORT ORG | WI | 501(C)(3) | TYPE III-FI | NA | false |
| GUNDERSEN LUTHERAN HEALTH SYSTEM INC | ||||||||||
| 1836 SOUTH AVE | LA CROSSE | WI | 54601 | 391866425 | SUPPORT ORG | WI | 501(C)(3) | TYPE II | BGHS | false |
| GUNDERSEN LUTHERAN MEDICAL CENTER INC | ||||||||||
| 1910 SOUTH AVE | LA CROSSE | WI | 54601 | 390813416 | HEALTHCARE | WI | 501(C)(3) | 3 | GLHS | false |
| GUNDERSEN CLINIC LTD | ||||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391028657 | HEALTHCARE | WI | 501(C)(3) | 3 | GLHS | false |
| GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES INC | ||||||||||
| 1910 SOUTH AVE | LA CROSSE | WI | 54601 | 391606449 | SUPPORT ORG | WI | 501(C)(3) | TYPE II | GLHS | false |
| GUNDERSEN LUTHERAN MEDICAL FOUNDATION INC | ||||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391249705 | FOUNDATION | WI | 501(C)(3) | 7 | GLHS | false |
| TRI-COUNTY MEMORIAL HOSPITAL INC | ||||||||||
| 18601 LINCOLN STREET | WHITEHALL | WI | 54773 | 390704510 | HEALTHCARE | WI | 501(C)(3) | 3 | GLHS | false |
| HARMONY COUMMUNITY HEALTHCARE INC | ||||||||||
| 815 MAIN AVE | SOUTH HARMONY | MN | 55939 | 410711606 | HEALTHCARE | WI | 501(C)(3) | 10 | GLHS | false |
| TWEETEN LUTHERAN HEALTHCARE CENTER INC | ||||||||||
| 125 FIFTH AVE SE | SPRING GROVE | MN | 55974 | 411565003 | HEALTHCARE | WI | 501(C)(3) | 10 | GLHS | false |
| TRI STATE AMBULANCE INC | ||||||||||
| 235 CAUSEWAY BOULEVARD | LA CROSSE | WI | 54603 | 391965415 | MEDICAL TRANSPORT | WI | 501(C)(3) | 3 | GLHS | false |
| TRI-STATE REGIONAL AMBULANCE INC | ||||||||||
| 235 CAUSEWAY BOULEVARD | LA CROSSE | WI | 54603 | 391962965 | MEDICAL TRANSPORT | WI | 501(C)(3) | 10 | GLHS | false |
| LUTHERAN REAL ESTATE HOLDING CORPORATION | ||||||||||
| 1910 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391480826 | HOUSING | WI | 501(C)(3) | TYPE III-FI | GLHS | false |
| COMMUNITY HOUSING OF LA CROSSE INC | ||||||||||
| 1900 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391586700 | INDEPENDENT LIVING | WI | 501(C)(3) | 10 | LREH CORP | false |
| LUTHERAN HOUSING OF LA CROSSE INC | ||||||||||
| 1900 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391751934 | INDEPENDENT LIVING | WI | 501(C)(3) | 10 | LREH CORP | false |
| ST JOSEPH'S HEALTH SERVICES INC | ||||||||||
| 400 WATER AVE | HILLSBORO | WI | 54634 | 390929538 | HEALTHCARE | WI | 501(C)(3) | 3 | GLHS | false |
| ST JOSEPH MEMORIAL FOUNDATION INC | ||||||||||
| 400 WATER AVE | HILLSBORO | WI | 54634 | 391455787 | FOUNDATION | WI | 501(C)(3) | TYPE I | STJ HLTH SVC | false |
| TRI-COUNTY MEMORIAL FOUNDATION INC | ||||||||||
| 18601 LINCOLN STREET | WHITEHALL | WI | 54773 | 300093022 | FOUNDATION | WI | 501(C)(3) | TYPE I | TCH | false |
| MEMORIAL HOSPITAL OF BOSCOBEL | ||||||||||
| 205 PARKER STREET | BOSCOBEL | WI | 53805 | 390845590 | HEALTHCARE | WI | 501(C)(3) | 3 | GLHS | false |
| PALMER LUTHERAN HEALTH CENTER INC | ||||||||||
| 112 JEFFERSON STREET | WEST UNION | IA | 52175 | 421320763 | HEALTHCARE | WI | 501(C)(3) | 3 | GLHS | false |
| MOUNDVIEW MEMORIAL HOSPITALS AND CLINICS | ||||||||||
| 402 WEST LAKE STREET | FRIENDSHIP | WI | 53934 | 390944012 | HEALTHCARE | WI | 501(C)(3) | 3 | GLHS | false |
| MEMORIAL HEALTHCARE FOUNDATION INC (MOUNDVIEW) | ||||||||||
| 402 WEST LAKE STREET | FRIENDSHIP | WI | 53934 | 391775074 | FOUNDATION | WI | 501(C)(3) | TYPE I | MDV HOSP | false |
| SAINT ELIZABETH'S HOSPITAL OF WABASHA INC WABASHA | ||||||||||
| 1200 FIFTH GRANT BLVD WEST | WABASHA | MN | 55981 | 410693877 | HEALTHCARE | WI | 501(C)(3) | 3 | GLHS | false |
| BELLIN HEALTH SYSTEMS INC | ||||||||||
| 744 SOUTH WEBSTER AVE | GREEN BAY | WI | 54301 | 391512904 | SUPPORT ORG | WI | 501(C)(3) | TYPE II | BGHS | false |
| LAKE MICHIGAN HEALTH SERVICES INC | ||||||||||
| 744 SOUTH WEBSTER AVE | GREEN BAY | WI | 54301 | 391512903 | SUPPORT ORG | WI | 501(C)(3) | TYPE II | BHS | false |
| BELLIN COLLEGE INC | ||||||||||
| 3201 EATON ROAD | GREEN BAY | WI | 54311 | 391620530 | EDUCATION | WI | 501(C)(3) | 2 | BHS | false |
| BELLIN PSYCHIATRIC CENTER INC | ||||||||||
| PO BOX 23725 | GREEN BAY | WI | 54301 | 391657627 | HEALTHCARE | WI | 501(C)(3) | 3 | BHS | false |
| BELLIN MEMORIAL HOSPITAL INC | ||||||||||
| 744 SOUTH WEBSTER AVE | GREEN BAY | WI | 54301 | 390884478 | HEALTHCARE | WI | 501(C)(3) | 3 | BHS | false |
| THE BELLIN HEALTH FOUNDATION INC | ||||||||||
| PO BOX 23400 | GREEN BAY | WI | 54301 | 391809171 | FOUNDATION | WI | 501(C)(3) | 7 | BHS | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| BEL-REGIONAL HOME MEDICAL INC | |||||||||
| 617 S ROOSEVELT | GREEN BAY | WI | 54301 | 391504766 | DURABLE MEDICAL EQUIPMENT, RETAIL PHARMACY, FITNESS | WI | NA | C CORPORATION | false |
| GUNDERSEN LUTHERAN ENVISION LLC | |||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54601 | 264706546 | RENEWABLE ENERGY | WI | NA | C CORPORATION | false |
| GUNDERSEN EDGE LLC | |||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54301 | 921783811 | INNOVATION | WI | NA | C CORPORATION | false |
| BG ASSURANCE COMPANY | |||||||||
| SELF INSURANCE | NA | C CORPORATION | false | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
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