VERNON MEMORIAL HEALTHCARE INC: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
VERNON MEMORIAL HEALTHCARE INC (EIN 39-0806404)
Tax period
2024-10-01 to 2025-09-30
Filed
2026-08-13
IRS object ID
202622259349302542
Schema version
2024v5.5
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)
Return2026-08-13T15:10:41-05:00ReturnTs
Tax Period End2025-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN393647910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI ADVISORY LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11502 LONDON ROAD SUITE 220AddressLine1Txt
CityDULUTHCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55812ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390806404EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1VERNON MEMORIAL HEALTHCARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlVERNBusinessNameControlTxt
Phone6086372101PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1507 SOUTH MAIN STREETAddressLine1Txt
CityVIROQUACityNm
State AbbreviationWIStateAbbreviationCd
ZIP54665ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSCOTT LECKEYPersonNm
Person TitleCFOPersonTitleTxt
Phone6086372101PhoneNum
Signature2026-08-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHAEL J PETERSON CPAPreparerPersonNm
PTINP01833529PTIN
Phone2187224705PhoneNum
Preparation2026-07-29PreparationDt
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDAVID HARTBERGPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1507 SOUTH MAIN STREETAddressLine1Txt
CityVIROQUACityNm
State AbbreviationWIStateAbbreviationCd
ZIP54665ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$97,085,734GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.VMH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1946FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionVERNON MEMORIAL HEALTHCARE, INC. IS DEDICATED TO INSPIRING PATIENT-CENTERED, COMPASSIONATE CARE IN OUR COMMUNITY. OUR VISION IS TO BE THE TRUSTED HEALTHCARE PARTNER THAT DELIVERS EXCEPTIONAL CARE TO EVERY GENERATION. WE UPHOLD OUR VALUES OF COMPASSION, EXCELLENCE, COLLABORATION, INTEGRITY, ACCOUNTABILITY, AND SUSTAINABILITY IN EVERY ASPECT OF OUR SERVICE. BY SHOWING AN AUTHENTIC DESIRE TO HELP OTHERS, PURSUING THE HIGHEST QUALITY CARE, WORKING SEAMLESSLY WITH ALL PARTNERS, COMMITTING TO HONESTY, TAKING OWNERSHIP OF OUR ACTIONS, AND CONSERVING RESOURCES TO SUPPORT HEALTH AND WELL-BEING, WE ENSURE THAT EVERY PATIENT RECEIVES THE BEST POSSIBLE CARE, CLOSE TO HOME.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee564TotalEmployeeCnt
Total Volunteers66TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$169,700PYContributionsGrantsAmt
CY Contributions Grants$67,012CYContributionsGrantsAmt
PY Program Service Revenue$92,181,470PYProgramServiceRevenueAmt
CY Program Service Revenue$94,048,109CYProgramServiceRevenueAmt
PY Investment Income$2,093,518PYInvestmentIncomeAmt
CY Investment Income$2,480,445CYInvestmentIncomeAmt
PY Other Revenue$538,894PYOtherRevenueAmt
CY Other Revenue$469,693CYOtherRevenueAmt
PY Total Revenue$94,983,582PYTotalRevenueAmt
CY Total Revenue$97,065,259CYTotalRevenueAmt
PY Grants And Similar Paid$66,594PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$127,953CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$45,965,427PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$50,642,891CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$42,683,817PYOtherExpensesAmt
CY Other Expenses$39,976,588CYOtherExpensesAmt
PY Total Expenses$88,715,838PYTotalExpensesAmt
CY Total Expenses$90,747,432CYTotalExpensesAmt
PY Revenues Less Expenses$6,267,744PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,317,827CYRevenuesLessExpensesAmt
Total Assets BOY$135,582,722TotalAssetsBOYAmt
Total Assets EOY$148,995,196TotalAssetsEOYAmt
Total Liabilities BOY$20,944,109TotalLiabilitiesBOYAmt
Total Liabilities EOY$22,705,912TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$114,638,613NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$126,289,284NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO INSPIRE PATIENT-CENTERED, COMPASSIONATE CARE IN OUR COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$58,582,830ExpenseAmt
Grant$127,953GrantAmt
Revenue$85,079,284RevenueAmt
DescVERNON MEMORIAL HEALTHCARE ("VMH") OPERATES A 25-BED CRITICAL ACCESS HOSPITAL LOCATED IN VIROQUA, WISCONSIN, FOUR PROVIDER-BASED RURAL HEALTH CLINICS (VIROQUA, LA FARGE, SOLDIERS GROVE, AND WESTBY), AND TWO RETAIL PHARMACY LOCATIONS. VMH MAINTAINS A CLEAR AND CONSISTENT COMMITMENT TO ITS CHARITABLE PURPOSE THROUGH THE PROVISION OF HEALTH AND WELLNESS SERVICES TO THE COMMUNITIES SERVED WITHOUT REGARD TO AGE, RACE, GENDER, CREED, NATIONAL ORIGINAL, ABILITY TO PAY, AND PHYSICAL OR MENTAL HANDICAP. VMH'S DEDICATED WORKFORCE EXEMPLIFIES SERVICE IN ALIGNMENT WITH ORGANIZATIONAL VALUE STATEMENTS: GREAT EXPERIENCES. RESPECTING EVERYONE. EXCELLENCE IN EVERYTHING WE DO. ALWAYS A HELPFUL ATTITUDE. TAKING CARE OF ONE ANOTHER.IN RESPONSE TO THE NEEDS OF THE COMMUNITIES SERVED, VMH IS PROUD TO PROVIDE HIGH QUALITY INPATIENT ACUTE CARE FOR MEDICAL, SURGICAL, OBSTETRICAL, AND NEWBORN SERVICE NEEDS. VMH FURTHER SUPPORTS THE NEEDS OF ITS PATIENTS BY OFFERING ACCESS TO SWING BED (SKILLED) NURSING CARE. WITH A CONSTANT FOCUS ON QUALITY AND PATIENT SAFETY, VMH OFFERS OUTPATIENT AND ANCILLARY HEALTHCARE SERVICES INCLUDING 24-HOUR EMERGENCY SERVICES, SURGICAL SERVICES, LABORATORY, X-RAY, ULTRASOUND, CT SCANS, MRI, MAMMOGRAPHY, CARDIAC REHABILITATION, INFUSION AND GASTROINTESTINAL SERVICES, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, AND NUTRITIONAL THERAPY INCLUDING DIABETIC EDUCATION. PATIENTS SERVED BY THE HOSPITAL IN FISCAL 2025 INCLUDED 1,996 ADULT AND PEDIATRIC INPATIENT DAYS AND 124 NEWBORN DELIVERIES. THERE WAS A TOTAL OF 1,760 SURGERY CASES (INPATIENT AND OUTPATIENT COMBINED) AND THERE WERE 94,523 TOTAL OUTPATIENT VISITS. THE VMH EMERGENCY ROOM PROVIDED IMMEDIATE ACCESS TO CARE IN RESPONSE TO 7,557 EMERGENCY ROOM VISITS.AS A PART OF VMH'S MISSION, AND IN KEEPING WITH ITS STATUS AS A NOT-FOR-PROFIT HEALTHCARE ORGANIZATION, VMH HAS ESTABLISHED A PATIENT FINANCIAL ASSISTANCE POLICY THAT SETS FORWARD THE CRITERIA BY WHICH A PATIENT MAY QUALIFY TO RECEIVE CARE AT AMOUNTS LESS THAN THE ESTABLISHED RATES; TO RECEIVE CHARITY CARE. VMH MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE PROVIDED, THE TOTAL HEALTHCARE SERVICES PROVIDED TO PATIENTS UNDER THIS POLICY ARE MEASURED IN BOTH TOTAL CHARGES AND AT THE ESTIMATED COST OF PROVIDING CARE TO PATIENTS WITH BOTH FIGURES REPORTED AND AVAILABLE BY REFERRING TO SCHEDULE H IN ADDITION, VMH IS A PROVIDER UNDER THE WISCONSIN MEDICAID PROGRAM. UNDER THE PROGRAM, VMH IS LEGALLY BOUND TO ACCEPT THE AMOUNT DETERMINED BY THE STATE OF WISCONSIN AS PAYMENT IN FULL FOR EACH PATIENT'S CHARGES EVEN THOUGH REIMBURSEMENT IS LESS THAN THE COST TO PROVIDE THE CARE, THEREFORE, SERVICE TO PATIENTS UNDER THIS PROGRAM SHOULD ALSO BE CONSIDERED PART OF THE ORGANIZATION'S BENEFIT PROVIDED TO THE COMMUNITY. (FOR ADDITIONAL INFORMATION ON VMH'S CHARITY CARE AND/OR THE COST OF PARTICIPATION IN THE WISCONSIN MEDICAID PROGRAM, PLEASE REFER TO SCHEDULE H OF FORM 990.) IN ADDITION, VMH ENGAGES IN A VARIETY OF COMMUNITY BENEFIT ACTIVITIES, PROVIDING A CRITICALLY IMPORTANT COMMUNITY BENEFIT THAT WOULD NOT OTHERWISE BE AVAILABLE IN THE COMMUNITIES SERVED WITHOUT THE EFFORTS AND SPECIALIZED KNOWLEDGE OF THE LOCAL HEALTHCARE TEAM.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$16,440,419ExpenseAmt
Grant$0GrantAmt
Revenue$8,968,825RevenueAmt
DescVERNON MEMORIAL HEALTHCARE, INC. OPERATES FOUR RURAL HEALTH CLINICS LOCATED IN VIROQUA, LAFARGE, SOLDIERS GROVE, AND WESTBY. TOGETHER, THESE CLINICS STRIVE TO MEET THE HEALTHCARE NEEDS OF PATIENTS AND FAMILIES WHO LIVE AND WORK IN THE COMMUNITIES THEY SERVE. A TOTAL OF 37,799 RURAL HEALTH CLINIC VISITS OCCURRED IN FISCAL YEAR 2025. THE CLINICS ARE DESIGNATED AS RURAL HEALTH CLINICS BY THE MEDICARE AND MEDICAID PROGRAMS AND, BY DEFINITION OF THE REQUIREMENTS FOR THAT DESIGNATION, ARE LOCATED IN RURAL OR UNDERSERVED AREAS OF THE COUNTRY. THESE CLINICS PROVIDE CARE TO A LARGE PORTION OF MEDICARE AND MEDICAID BENEFICIARIES WHO, WITHOUT ACCESS TO CARE LOCALLY, WOULD BE REQUIRED TO TRAVEL FARTHER DISTANCES FOR QUALITY HEALTHCARE.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$75,023,249TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document54IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee564EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SCOTT LECKEYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6086374964PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1507 SOUTH MAIN STREETAddressLine1Txt
CityVIROQUACityNm
State AbbreviationWIStateAbbreviationCd
ZIP54665ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
PETER HUGHES
CHAIR1.00Yes (X)Yes (X)$0$0$0
STACI KRING
VICE CHAIR1.00Yes (X)Yes (X)$0$0$0
PAUL LARSEN
TREASURER (THRU 12/2024)1.00Yes (X)Yes (X)$0$0$0
TOM WESTON
TREASURER1.00Yes (X)Yes (X)$0$0$0
VICKI ANDERSON
SECRETARY (THRU 12/2024)1.00Yes (X)Yes (X)$0$0$0
MICHELLE ENGH
SECRETARY1.00Yes (X)Yes (X)$0$0$0
SANDRA MALLIET
MEMBER1.00Yes (X)$0$0$0
STEVE MICHAELS
MEMBER1.00Yes (X)$0$0$0
JOAN PETERSON
MEMBER1.00Yes (X)$0$0$0
KIMBERLY TURNMIRE
MEMBER1.00Yes (X)$0$0$0
JAY VOSSETEIG
MEMBER1.00Yes (X)$0$0$0
TONYA WAGNER
MEMBER1.00Yes (X)$0$0$0
PAUL WOODWARD
MEMBER1.00Yes (X)$0$0$0
DAVID HARTBERG
CEO40.00Yes (X)$437,056$0$40,950
SCOTT LECKEY
CFO40.00Yes (X)$296,993$0$24,099
ROBERT LOVEJOY
COO40.00Yes (X)$250,753$0$31,920
TAUQEER QAZI
CMO (BEG. 09/2025)40.00Yes (X)$0$0$0
DEBORAH PRIOR
ER PHYSICIAN30.00$553,961$0$39,798Yes (X)
JEFFREY SCHEIDT
CRNA40.00$442,931$0$42,505Yes (X)
ADAM WUENSCH
ER PHYSICIAN40.00$423,581$0$28,310Yes (X)
MITCHELL WILKINS
CRNA30.00$327,688$0$9,585Yes (X)
KENNETH HALLWOOD
CRNA40.00$169,433$0$3,692Yes (X)
KRISTY WILTROUT
FORMER CNO40.00$288,974$0$20,701Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,191,370TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$241,560TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K91IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
GUNDERSEN LUTHERAN MEDICAL CENTER
1900 SOUTH AVE NCA1-01LACROSSEWI54601MEDICAL SERVICES$3,056,574
BURLINGTON HEALTHCARE PROVIDERS
PO BOX 180512DELAFIELDWI53018STAFFING SERVICES$886,900
MIRON CONSTRUCTION
PO BOX 1372GREEN BAYWI543051372REPAIRS AND MAINTANANCE$527,657
POELLINGER ELECTRIC
5416 33RD STREETLACROSSEWI54601REPAIRS AND MAINTANANCE$458,461
S&S MECHANICAL
1815 CALEDONIA STLACROSSEWI54603REPAIRS AND MAINTANANCE$428,471
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K23CntrctRcvdGreaterThan100KCnt
All Other Contributions$67,012AllOtherContributionsAmt
Total Contributions$67,012TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
HOSPITAL621990$73,066,874$73,066,874
RETAIL PHARMACY456110$11,094,942$11,094,942
CLINIC621110$8,968,825$8,968,825

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$917,468TotalRevenueColumnAmt
Related Or Exempt Func Income$917,468RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$94,048,109TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,500,920TotalRevenueColumnAmt
Exclusion$2,500,920ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$334,957RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$334,957RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$334,957TotalRevenueColumnAmt
Exclusion$334,957ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$20,475OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$20,475OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$20,475TotalRevenueColumnAmt
Exclusion-$20,475ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCAFETERIA REVENUEDesc
Business722514BusinessCd
Total Revenue Column$134,736TotalRevenueColumnAmt
Exclusion$134,736ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$134,736OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$97,065,259TotalRevenueColumnAmt
Related Or Exempt Func Income$94,048,109RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,950,138ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$78,470TotalAmt
Program Services$78,470ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$49,483TotalAmt
Program Services$49,483ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,190,304TotalAmt
Program Services$333,148ProgramServicesAmt
Management And General$857,156ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$38,271,195TotalAmt
Program Services$33,166,458ProgramServicesAmt
Management And General$5,104,737ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,052,599TotalAmt
Program Services$966,879ProgramServicesAmt
Management And General$85,720ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,529,025TotalAmt
Program Services$6,826,183ProgramServicesAmt
Management And General$702,842ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,599,768TotalAmt
Program Services$2,342,710ProgramServicesAmt
Management And General$257,058ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$204,100TotalAmt
Program Services$16,287ProgramServicesAmt
Management And General$187,813ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$5,989TotalAmt
Management And General$5,989ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$83,477TotalAmt
Management And General$83,477ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$6,906,617TotalAmt
Program Services$5,604,240ProgramServicesAmt
Management And General$1,302,377ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$316,956TotalAmt
Program Services$311,605ProgramServicesAmt
Management And General$5,351ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$376,298TotalAmt
Program Services$170,021ProgramServicesAmt
Management And General$206,277ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,007,982TotalAmt
Program Services$23,076ProgramServicesAmt
Management And General$984,906ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,598,156TotalAmt
Program Services$1,567,810ProgramServicesAmt
Management And General$30,346ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$39,057TotalAmt
Program Services$19,535ProgramServicesAmt
Management And General$19,522ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$243,467TotalAmt
Program Services$188,746ProgramServicesAmt
Management And General$54,721ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$475,820TotalAmt
Program Services$384,847ProgramServicesAmt
Management And General$90,973ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,098,785TotalAmt
Program Services$3,315,134ProgramServicesAmt
Management And General$783,651ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$393,292TotalAmt
Program Services$80,327ProgramServicesAmt
Management And General$312,965ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PHARMACEUTICALS$11,782,946$11,782,946
SUPPLIES$3,651,520$3,636,877$14,643
BAD DEBT EXPENSE$2,487,285$2,487,285
EQUIPMENT RENTAL & MAIN$1,723,174$1,606,808$116,366

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$4,581,667TotalAmt
Program Services$64,374ProgramServicesAmt
Management And General$4,517,293ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$90,747,432TotalAmt
Program Services$75,023,249ProgramServicesAmt
Management And General$15,724,183ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$6,289,806BOYAmt
EOY$8,107,460EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$17,205,110BOYAmt
EOY$13,304,979EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$192,520BOYAmt
EOY$208,491EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$8,916,109BOYAmt
EOY$9,818,297EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,718,925BOYAmt
EOY$2,882,810EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$453,815BOYAmt
EOY$914,033EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$99,400,906LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$61,116,692LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$37,015,170BOYAmt
EOY$38,284,214EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$57,657,961BOYAmt
EOY$66,671,122EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$133,193BOYAmt
EOY$141,183EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,000,113BOYAmt
EOY$8,662,607EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$135,582,722BOYAmt
EOY$148,995,196EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,804,586BOYAmt
EOY$7,116,951EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,529,851BOYAmt
EOY$11,511,446EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,609,672BOYAmt
EOY$4,077,515EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,944,109BOYAmt
EOY$22,705,912EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$114,446,093BOYAmt
EOY$126,080,793EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$192,520BOYAmt
EOY$208,491EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$114,638,613BOYAmt
EOY$126,289,284EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$135,582,722BOYAmt
EOY$148,995,196EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$6,317,827ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$5,332,844NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$5,989OtherActivitiesAmt
Total Lobbying Expenditures$5,989TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationVERNON MEMORIAL HEALTHCARE, INC. PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES 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 CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,512,508OtherCostOrOtherBasisAmt
Book Value$1,512,508BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$65,938,304OtherCostOrOtherBasisAmt
Depreciation$41,254,407DepreciationAmt
Book Value$24,683,897BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$29,329,114OtherCostOrOtherBasisAmt
Depreciation$19,862,285DepreciationAmt
Book Value$9,466,829BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,620,980OtherCostOrOtherBasisAmt
Book Value$2,620,980BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$38,284,214TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
AMOUNTS RECEIVABLE FROM THIRD-PARTY REIMBURSEMENT PROGRAMS$4,387,193
OTHER RECEIVABLES$1,131,075
DEFERRED COMPENSATION PLAN$3,084,799
DUE FROM FOUNDATION$59,540
FieldValueIRS element (for citing)
Total Book Value Other Assets$8,662,607TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DEFERRED COMPENSATION PLAN LIABILITY$3,117,515
MEDICAL CLAIMS PAYABLE$960,000
FieldValueIRS element (for citing)
Total Liability$4,077,515TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$99,811,370TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$5,332,844NetUnrealizedGainsInvstAmt
Other Revenue-$2,487,285OtherRevenueAmt
Revenue Not Reported$2,845,559RevenueNotReportedAmt
Revenue Subtotal$96,965,811RevenueSubtotalAmt
Investment Expenses Not Incld$83,477InvestmentExpensesNotIncldAmt
Other Revenues Not Included$15,971OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$99,448RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$97,065,259TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$88,176,670TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$88,176,670ExpensesSubtotalAmt
Investment Expenses Not Incld2$83,477InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$2,487,285OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,570,762ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$90,747,432TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:BAD DEBT EXPENSE NET AGAINST REVENUE -2,487,285.
PART XI, LINE 4B - OTHER ADJUSTMENTS:CONTRIBUTIONS TO RESTRICTED NET ASSETS 33,992. NET ASSETS RELEASED FROM RESTRICTIONS -18,021.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE NET AGAINST REVENUE 2,487,285.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,299,611TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,299,611NetCommunityBenefitExpnsAmt
Total Expense0.01520TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,942,980TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,495,945DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,447,035NetCommunityBenefitExpnsAmt
Total Expense0.01690TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,242,591TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,495,945DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,746,646NetCommunityBenefitExpnsAmt
Total Expense0.03210TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$51,280TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$51,280NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$845,600TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$845,600NetCommunityBenefitExpnsAmt
Total Expense0.00990TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,265,067TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,781,209DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,483,858NetCommunityBenefitExpnsAmt
Total Expense0.01740TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,934TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$26,934NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,188,881TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,781,209DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,407,672NetCommunityBenefitExpnsAmt
Total Expense0.02820TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,431,472TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,277,154DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,154,318NetCommunityBenefitExpnsAmt
Total Expense0.06030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$2,306,268BadDebtExpenseAmt
Bad Debt Expense Attributable$1,153,134BadDebtExpenseAttributableAmt
Reimbursed By Medicare$13,686,555ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$13,716,906CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$30,351MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1VERNON MEMORIAL HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1507 SOUTH MAIN STAddressLine1Txt
CityVIROQUACityNm
State AbbreviationWIStateAbbreviationCd
ZIP54665ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.VMH.ORGWebsiteAddressTxt
State License1053StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1VERNON MEMORIAL HEALTHCARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
OtherYes (X)OtherInd
CHNA Conducted23CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION C, LINE 7DOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSEE PART V, SECTION C, LINE 7DOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt23ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION C, LINE 7DStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, PAGE 8FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, PAGE 8FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, PAGE 8FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 3J: MENTAL HEALTH INITIATIVES:- EXPANDED BEHAVIORAL HEALTH SERVICES BY ADDING NEW PROVIDERS.- CONDUCTED PUBLIC AWARENESS CAMPAIGNS TO REDUCE MENTAL HEALTH STIGMA.- INTEGRATED MENTAL HEALTH SERVICES INTO PRIMARY CARE CLINICS.- ESTABLISHED COMMUNITY CLUBS TO MITIGATE LONELINESS.- TRAINED STAFF ON MENTAL HEALTH SUPPORT.ADDRESSING SOCIAL & ECONOMIC ISSUES:- ORGANIZED QUARTERLY FOOD DRIVES AND DISTRIBUTED HUNGER RESOURCE PACKETS.- COLLABORATED WITH COMMUNITY PARTNERS TO ENHANCE FOOD ACCESS POINTS.- ASSISTED PATIENTS IN ACCESSING FINANCIAL ASSISTANCE PROGRAMS.- CONDUCTED INTERNAL DIVERSITY AND SOCIAL CONDITIONS TRAINING.- EXPANDED COMMUNITY GARDENS AND PARTNERSHIPS WITH FARMERS MARKETS.IMPROVING HEALTHCARE ACCESS:- LAUNCHED PUBLIC AWARENESS CAMPAIGNS FOR PREVENTIVE SCREENINGS.- EDUCATED COMMUNITY MEMBERS ON USING MYCHART FOR SCHEDULING.- CONDUCTED DEDICATED CANCER SCREENING CAMPAIGNS.- UTILIZED TECHNOLOGY TO STREAMLINE SCREENING PROCESSES.- PROVIDED FINANCIAL ASSISTANCE EDUCATION FOR PREVENTIVE SCREENINGS.COMMUNITY COLLABORATION:- PARTNERED WITH LOCAL HEALTH DEPARTMENTS, SCHOOL DISTRICTS, AND AGENCIES.- ENGAGED IN JOINT INITIATIVES TO ADDRESS IDENTIFIED HEALTH NEEDS.- SUPPORTED OTHER ORGANIZATIONS IN MEETING COMMUNITY HEALTH NEEDS.PUBLIC HEALTH CAMPAIGNS:- INCREASED AWARENESS ABOUT MENTAL HEALTH AND AVAILABLE SERVICES.- PROMOTED HEALTHY EATING AND PHYSICAL ACTIVITY.- ADDRESSED SUBSTANCE ABUSE AND ITS IMPACT ON MENTAL HEALTH.- EMPHASIZED THE IMPORTANCE OF TIMELY HEALTHCARE ACCESS.
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 5: THE SURVEY WAS CONDUCTED USING MIXED METHODS, AND RESPONDENTS COULD EITHER COMPLETE THEIR SURVEY ONLINE OR SUBMIT A PAPER COPY OF THEIR SURVEY RESPONSE. GREAT RIVERS UNITED WAY STAFF AND VOLUNTEERS ENTERED PAPER SURVEY RESPONSES INTO A QUALTRICS SURVEY PORTAL PROVIDED BY COMMUNITY HEALTH SOLUTIONS. THE SURVEY WAS CONDUCTED IN PARTNERSHIP WITH A WIDE RANGE OF COMMUNITY PARTNERS THAT HELPED RAISE AWARENESS AND ENCOURAGE COMMUNITY MEMBERS TO COMPLETE THE SURVEY. IN PLANNING THE SURVEY, THE PROJECT PARTNERS BEGAN WITH A COMMON AIM TO CONDUCT AN INCLUSIVE SURVEY WITH INSIGHTS FROM A WIDE ARRAY OF COMMUNITY MEMBERS. IT SHOULD BE NOTED THAT THE SURVEYS WERE CONDUCTED USING CONVENIENCE SAMPLING. CONVENIENCE SAMPLING IS A PRACTICAL APPROACH FOR OBTAINING INSIGHTS FROM AS MANY PEOPLE AS POSSIBLE, BUT WITHOUT RANDOM SELECTION. THE RESULTS OF A CONVENIENCE SAMPLE ARE INSTRUCTIVE FOR UNDERSTANDING THE SCOPE OF ISSUES AND OPPORTUNITIES IN A COMMUNITY; HOWEVER, RESULTS MIGHT NOT BE STATISTICALLY REPRESENTATIVE OF THE ENTIRE POPULATION OF A COMMUNITY. A TOTAL OF 1,238 INDIVIDUALS SUBMITTED A RESPONSE TO THE SURVEY (ALTHOUGH NOT EVERY RESPONDENT COMPLETED EVERY ITEM). A PROFILE OF THE SURVEY RESPONDENTS IS PROVIDED IN EXHIBIT 1.3. AS SHOWN IN THE EXHIBIT:THE NUMBER OF SURVEYS COMPLETED BY COUNTY RANGED FROM 89 IN HOUSTON COUNTY AND TREMPEALEAU COUNTY TO 536 IN LA CROSSE COUNTY. NOTING THIS WIDE RANGE OF RESPONSES, IT IS IMPORTANT TO VIEW THE SURVEY RESULTS AT THE COUNTY LEVEL AND RECOGNIZE THAT THE HIGHER NUMBER OF RESPONSES FROM LA CROSSE COUNTY AND MONROE COUNTY HAVE A SKEWING EFFECT ON THE REGIONAL RESULTS. THE SURVEY RESPONDENTS WERE PREDOMINANTLY FEMALE (77%), AS IS COMMON IN COMMUNITY SURVEY OF THIS TYPE. BEYOND THE DIFFERENCE IN FEMALE VS. MALE RESPONDENTS, THE DEMOGRAPHIC PROFILE FOR SURVEY RESPONDENTS GENERALLY (THOUGH NOT PRECISELY) REFLECTS THE OVERALL DISTRIBUTION OF THE POPULATION BY SELECTED INDICATORS OF AGE, RACE, ETHNICITY, AND INCOME.
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 6A: THE COMPASS NOW 2024 PARTNERSHIP WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS:1. GUNDERSEN HEALTH SYSTEM, LA CROSSE2. MAYO CLINIC HEALTH SYSTEM, LA CROSSE AND SPARTA3. GUNDERSEN ST. JOSEPH'S HOSPITAL AND CLINICS, HILLSBORO4. GUNDERSEN TRI-COUNTY HOSPITAL AND CLINICS, WHITEHALL5. TOMAH HEALTH, TOMAH
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 6B: THE COMPASS NOW 2024 PARTNERSHIP WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING ORGANIZATIONS:1. GREAT RIVERS UNITED WAY2. TREMPEALEAU COUNTY HEALTH DEPARTMENT3. MONROE COUNTY HEALTH DEPARTMENT5. VERNON COUNTY HEALTH DEPARTMENT6. LA CROSSE COUNTY HEALTH DEPARTMENT7. BUFFALO COUNTY HEALTH DEPARTMENT8. HOUSTON COUNTY HEALTH DEPARTMENT (MINNESOTA)9. COULEECAP10. LA CROSSE COUNTY HUMAN SERVICES
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 7D: PART V, SECTION B, LINE 7A:HTTPS://WWW.VMH.ORG/COMMUNITY-INVOLVEMENT/PART V, SECTION B, LINE 7B:HTTPS://WWW.GREATRIVERSUNITEDWAY.ORG/WP-CONTENT/UPLOADS/2024/08/COMPASS-NOW-2024_WEB.PDFPART V, SECTION B, LINE 10A:HTTPS://WWW.VMH.ORG/COMMUNITY-INVOLVEMENT/
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 11: BASED ON THE 2024 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION PLAN, HERE IS HOW VERNON MEMORIAL HEALTHCARE (VMH) IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENT CHNA:ADDRESSING SIGNIFICANT NEEDS- MENTAL HEALTH: - ACTIONS TAKEN: - EXPANDED BEHAVIORAL HEALTH SERVICES BY ADDING NEW PROVIDERS. - CONDUCTED PUBLIC AWARENESS CAMPAIGNS TO REDUCE MENTAL HEALTH STIGMA. - INTEGRATED MENTAL HEALTH SERVICES INTO PRIMARY CARE CLINICS. - ESTABLISHED COMMUNITY CLUBS TO MITIGATE LONELINESS. - TRAINED STAFF ON MENTAL HEALTH SUPPORT. - REASON FOR ACTION: HIGH CONCERN ABOUT MENTAL HEALTH AND STIGMA AMONG COMMUNITY MEMBERS.- SOCIAL & ECONOMIC ISSUES: - ACTIONS TAKEN: - ORGANIZED QUARTERLY FOOD DRIVES AND DISTRIBUTED HUNGER RESOURCE PACKETS. - COLLABORATED WITH COMMUNITY PARTNERS TO ENHANCE FOOD ACCESS POINTS. - ASSISTED PATIENTS IN ACCESSING FINANCIAL ASSISTANCE PROGRAMS. - CONDUCTED INTERNAL DIVERSITY AND SOCIAL CONDITIONS TRAINING. - EXPANDED COMMUNITY GARDENS AND PARTNERSHIPS WITH FARMERS MARKETS. - REASON FOR ACTION: SIGNIFICANT CHALLENGES RELATED TO FOOD ACCESS AND ECONOMIC STABILITY, WITH MANY HOUSEHOLDS LIVING AT OR BELOW THE POVERTY LINE.- HEALTHCARE ACCESS: - ACTIONS TAKEN: - LAUNCHED PUBLIC AWARENESS CAMPAIGNS FOR PREVENTIVE SCREENINGS. - EDUCATED COMMUNITY MEMBERS ON USING MYCHART FOR SCHEDULING. - CONDUCTED DEDICATED CANCER SCREENING CAMPAIGNS. - UTILIZED TECHNOLOGY TO STREAMLINE SCREENING PROCESSES. - PROVIDED FINANCIAL ASSISTANCE EDUCATION FOR PREVENTIVE SCREENINGS. - REASON FOR ACTION: DIFFICULTY IN SCHEDULING APPOINTMENTS AND THE NEED TO IMPROVE PARTICIPATION IN PREVENTIVE SCREENINGS.
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 13B: PATIENTS' RELIANCE ON MEDICARE OR MEDICAL ASSISTANCE.
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 13H: THE ORGANIZATION PROVIDES "CATASTROPHIC CARE" FOR PATIENTS NOT MEETING FINANCIAL ASSISTANCE ELIGIBILITY. THESE PATIENTS MAY BE ELIGIBLE FOR ASSISTANCE UNDER CIRCUMSTANCES WHEN MEDICAL BILLS WOULD RESULT IN SEVERE FINANCIAL HARDSHIP. PATIENTS, OR THEIR GUARANTORS, MAY BE ELIGIBLE FOR CATASTROPHIC CARE ASSISTANCE IF THEY INCURRED OUT-OF-POCKET OBLIGATIONS RESULTING FROM MEDICAL SERVICES PROVIDED BY VERNON MEMORIAL HEALTHCARE, INC. THAT EXCEED 25% OF THE ADJUSTED GROSS INCOME AND HAVE ASSETS BELOW THE EQUIVALENT OF 600% OF THE FPL THRESHOLD.
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 15E: LANGUAGE TAGLINES FOR ASSISTANCE
SCHEDULE H, PART V, LINE 16A-C:LINE 16A, FINANCIAL ASSISTANCE POLICY:HTTPS://WWW.VMH.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/LINE 16B, FINANCIAL ASSISTANCE APPLICATION:HTTPS://WWW.VMH.ORG/WP-CONTENT/UPLOADS/2025/01/2022-FAP-APPLICATION.PDFLINE 16C, FINANCIAL ASSISTANCE PROGRAM PLAIN LANGUAGE SUMMARY:HTTPS://WWW.VMH.ORG/WP-CONTENT/UPLOADS/2025/01/BRANDING-BROCHURE-FINANCIALASSISTANCEONLINE.PDF
FieldValueIRS element (for citing)
Facility7FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - HIRSCH CLINIC
407 S MAIN ST SUITE 400VIROQUAWI54665PROVIDER BASED RURAL HEALTH CLINIC
2 - LAFARGE MEDICAL CLINIC
206 N MILL STLAFARGEWI54639PROVIDER BASED RURAL HEALTH CLINIC
3 - VERNON MEMORIAL HEALTHCARE PHARMACY
407 S MAIN ST SUITE 400VIROQUAWI54665PHARMACY
4 - BLAND CLINIC
100 MELBY STWESTBYWI54667PROVIDER BASED RURAL HEALTH CLINIC
5 - VERNON MEMORIAL PHARMACY - LAFARGE
206 N MILL STREETLAFARGEWI54639PHARMACY
6 - SOLAR TOWN PHARMACY
104 SUNSET AVESOLDIERS GROVEWI54655PHARMACY
7 - KICKAPOO VALLEY MEDICAL CLINIC
102 SUNSET AVESOLDIERS GROVEWI54655PROVIDER BASED RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:CATASTROPHIC CARE: PATIENTS NOT MEETING FINANCIAL ASSISTANCE ELIGIBILITY THRESHOLDS MAY BE ELIGIBLE FOR ASSISTANCE UNDER CIRCUMSTANCES WHEN MEDICAL BILLS WOULD RESULT IN SEVERE FINANCIAL HARDSHIP. PATIENTS, OR THEIR GUARANTORS, MAY BE ELIGIBLE FOR CATASTROPHIC CARE ASSISTANCE IF THEY INCURRED OUT-OF-POCKET OBLIGATIONS RESULTING FROM MEDICAL SERVICES PROVIDED BY VERNON MEMORIAL HEALTHCARE, INC. THAT EXCEED 25% OF THE ADJUSTED GROSS INCOME AND HAVE ASSETS BELOW THE EQUIVALENT OF 600% OF THE FPL THRESHOLD.
PART I, LINE 7:THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS COSTING METHODS FOR THE FORM 990.
PART I, LINE 7G:THE HOSPITAL IS REPORTING THE ACTIVITY OF THEIR 4 RURAL CLINICS ON PART I, LINE 7G AS SUBSIDIZED HEALTH SERVICES. AMOUNTS PRESENTED ARE TOTALS LESS AMOUNTS ALREADY RECORDED AS CHARITY CARE, MEDICAID AND BAD DEBT IN OTHER SECTIONS OF SCHEDULE H.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 5,226,135.
PART II, COMMUNITY BUILDING ACTIVITIES:OUR HOSPITAL PROVIDES CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. IN ADDITION, WE BELIEVE THE HOSPITAL DELIVERS A VITAL COMMUNITY BENEFIT THAT IS NOT EASILY MEASURED. LIKE MANY RURAL HOSPITALS, OUR ORGANIZATION EXISTS TO ENSURE LOCAL ACCESS TO A BROAD RANGE OF ESSENTIAL HEALTH SERVICES THAT WOULD OTHERWISE REQUIRE PATIENTS TO TRAVEL LONG DISTANCES.THESE SERVICES INCLUDE A BIRTHING CENTER; DIAGNOSTIC SERVICES; EMERGENCY AND URGENT CARE; INFUSION SERVICES; INPATIENT CARE; LABORATORY SERVICES; OCCUPATIONAL HEALTH; REHABILITATION SERVICES; SPECIALTY MEDICAL CARE; SPEECH AND AUDIOLOGY SERVICES; SURGICAL SERVICES; AND WOMEN'S HEALTH. BY OFFERING THESE SERVICES LOCALLY, THE HOSPITAL PLAYS A CRITICAL ROLE IN SUPPORTING THE HEALTH, SAFETY, AND WELL-BEING OF THE COMMUNITY IT SERVES.
PART III, LINE 4:ACCOUNTS RECEIVABLE AND CREDIT POLICY:IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE.
PART III, LINE 8:VERNON MEMORIAL HEALTHCARE, INC. IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND AS SUCH A PORTION OF ITS REVENUES ARE PAID UNDER A COST REIMBURSEMENT SYSTEM. BASED ON THE INSTRUCTIONS, THE TOTAL MEDICARE REVENUE SHOWN ON THIS FORM 990 INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE THAT IS ACTUALLY RECEIVED BY THE HOSPITAL FROM THE MEDICARE PROGRAM. THE AMOUNTS LISTED FOR MEDICARE DO NOT INCLUDE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT METHODOLOGY AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT VERNON MEMORIAL HEALTHCARE, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREA. THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES WHICH THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THE RECIPIENTS ARE TYPICALLY ELDERLY AND/OR DISABLED MEMBERS OF THE COMMUNITY AND ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY.
PART III, LINE 9B:IN ORDER TO PROVIDE THE LEVEL OF AID NECESSARY TO THE GREATEST NUMBER OF PATIENTS IN NEED, AND PROTECT THE RESOURCES NEEDED TO DO SO, THE FOLLOWING GUIDELINES APPLY: 1) SERVICES ARE PROVIDED UNDER CHARITY CARE ONLY WHEN DEEMED MEDICALLY NECESSARY AND AFTER PATIENTS ARE FOUND TO HAVE MET ALL FINANCIAL CRITERIA BASED ON THE DISCLOSURE OF PROPER INFORMATION AND DOCUMENTATION. 2) CHARITY CARE IS NOT AVAILABLE FOR ELECTIVE PROCEDURES. 3) PATIENTS ARE EXPECTED TO CONTRIBUTE PAYMENT FOR CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION; THEREFORE, EACH CASE WILL BE REVIEWED SEPARATELY. 4) CHARITY CARE IS NOT CONSIDERED AN ALTERNATIVE OPTION FOR PAYMENT AND PATIENTS MAY BE ASSISTED IN FINDING OTHER MEANS OF PAYMENT OR FINANCIAL ASSISTANCE BEFORE APPROVAL FOR CHARITY CARE. 5) UNINSURED PATIENTS WHO ARE BELIEVED TO HAVE THE FINANCIAL ABILITY TO PURCHASE HEALTH INSURANCE MAY BE ENCOURAGED TO DO SO IN ORDER TO ENSURE HEALTHCARE ACCESSIBILITY AND OVERALL WELL-BEING.
PART VI, LINE 2:VERNON HEALTH USES A VARIETY OF APPROACHES TO UNDERSTAND AND EVALUATE THE NEEDS OF THE COMMUNITIES IT SERVES. ALONGSIDE A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) COMPLETED IN PARTNERSHIP WITH NEIGHBORING HEALTHCARE ORGANIZATIONS, GREAT RIVERS UNITED WAY, AND LOCAL COUNTY HEALTH DEPARTMENTS, THE ORGANIZATION ALSO RELIES ON SEVERAL INFORMAL FEEDBACK CHANNELS. THESE INCLUDE FOCUS GROUPS AND ADVISORY COUNCILS, CONVERSATIONS WITH LOCAL EMPLOYERS, AND ONLINE SURVEYS.ACTIVE INVOLVEMENT ON LOCAL AND STATE BOARDS AND COMMITTEES FURTHER HELPS VERNON HEALTH REMAIN INFORMED ABOUT EVOLVING COMMUNITY PRIORITIES. THE ORGANIZATION ALSO WORKS CLOSELY WITH A WIDE RANGE OF COMMUNITY PARTNERS SUCH AS CHURCHES, BUSINESSES, AGENCIES, SCHOOLS, AND OTHER ORGANIZATIONS TO GAIN ADDITIONAL PERSPECTIVE ON LOCAL NEEDS.BOARD MEMBERS, WHO REPRESENT THE VARIOUS COMMUNITIES SERVED, REGULARLY INTERACT WITH RESIDENTS AND LOCAL COMMUNITIES TO GATHER FEEDBACK ON SERVICES AND BETTER UNDERSTAND COMMUNITY CONCERNS. IN ADDITION, SOCIAL MEDIA METRICS AND ONLINE ENGAGEMENT TRENDS ARE REVIEWED TO IDENTIFY EMERGING ISSUES AND INTERESTS. TO COMPLEMENT THESE EFFORTS, PATIENT SATISFACTION SURVEYS ARE SHARED FOLLOWING VISITS TO CAPTURE DIRECT FEEDBACK ON THE CARE EXPERIENCE.
PART VI, LINE 3:VERNON HEALTH USES A COMPREHENSIVE MIX OF METHODS TO COLLECT AND EVALUATE DATA RELATED TO THE NEEDS OF THE COMMUNITIES IT SERVES. ALONG WITH A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED IN PARTNERSHIP WITH NEIGHBORING HEALTHCARE ORGANIZATIONS, GREAT RIVERS UNITED WAY, AND COUNTY HEALTH DEPARTMENTS, THE ORGANIZATION ALSO RELIES ON INFORMAL FEEDBACK TOOLS SUCH AS FOCUS AND ADVISORY GROUPS, CONVERSATIONS WITH LOCAL EMPLOYERS, AND ONLINE SURVEYS.THE ORGANIZATION STAYS INFORMED ABOUT EVOLVING COMMUNITY PRIORITIES THROUGH ACTIVE PARTICIPATION ON LOCAL AND STATE BOARDS AND COMMITTEES. ADDITIONAL INSIGHT IS GAINED THROUGH COLLABORATION WITH COMMUNITY PARTNERS, INCLUDING ORGANIZATIONS, CHURCHES, BUSINESSES, AGENCIES, AND SCHOOLS. BOARD MEMBERS, WHO REPRESENT THE DIVERSE COMMUNITIES SERVED, REGULARLY ENGAGE WITH RESIDENTS TO BETTER UNDERSTAND THEIR CONCERNS AND EXPERIENCES ACCESSING CARE.FURTHER PERSPECTIVES ON COMMUNITY NEEDS ARE OBTAINED BY REVIEWING SOCIAL MEDIA ANALYTICS AND ONLINE ENGAGEMENT TRENDS. PATIENT INPUT IS ALSO GATHERED THROUGH POST-VISIT SURVEYS, PROVIDING VALUABLE FEEDBACK ON THE QUALITY OF CARE DELIVERED.IN ADDITION, VERNON HEALTH INFORMS AND EDUCATES PATIENTS AND INDIVIDUALS BILLED FOR CARE ABOUT THEIR POTENTIAL ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS AT THE FEDERAL, STATE, AND LOCAL LEVELS. THIS INFORMATION IS SHARED THROUGH MULTIPLE CHANNELS, INCLUDING REGISTRATION AND INTAKE PROCESSES, BILLING STATEMENTS, FINANCIAL COUNSELING SERVICES, PATIENT FINANCIAL ASSISTANCE POLICIES, WRITTEN MATERIALS, AND ONLINE RESOURCES. STAFF ARE TRAINED TO GUIDE PATIENTS THROUGH AVAILABLE OPTIONS, CONNECT THEM WITH APPROPRIATE ASSISTANCE PROGRAMS, AND SUPPORT APPLICATION PROCESSES TO ENSURE PATIENTS ARE AWARE OF AND ABLE TO ACCESS FINANCIAL SUPPORT RESOURCES WHEN NEEDED.
PART VI, LINE 4:VERNON HEALTH SERVES A PREDOMINANTLY RURAL REGION IN SOUTHWESTERN WISCONSIN, WITH A PRIMARY SERVICE AREA CENTERED AROUND VIROQUA AND THE SURROUNDING COMMUNITIES OF WESTBY, READSTOWN, SOLDIERS GROVE, CASHTON, AND LAFARGE, AS WELL AS NEARBY RURAL TOWNSHIPS. THIS PRIMARY SERVICE AREA ENCOMPASSES AN ESTIMATED POPULATION OF APPROXIMATELY 28,000 RESIDENTS.THE ORGANIZATION'S SECONDARY SERVICE AREA EXTENDS TO ADDITIONAL NEIGHBORING COMMUNITIES, INCLUDING DESOTO, FERRYVILLE, HILLSBORO, COON VALLEY, RICHLAND CENTER, GAYS MILLS, VIOLA, AND ONTARIO, INCREASING THE TOTAL POPULATION SERVED BY APPROXIMATELY 25,000 INDIVIDUALS.THE COMMUNITIES SERVED BY VERNON HEALTH ARE LARGELY RURAL IN NATURE AND ARE CHARACTERIZED BY AN AGING POPULATION AND GENERALLY MODEST HOUSEHOLD INCOME LEVELS. THESE DEMOGRAPHIC FACTORS INFLUENCE HEALTHCARE ACCESS, UTILIZATION, AND SERVICE NEEDS ACROSS THE REGION AND ARE KEY CONSIDERATIONS IN THE ORGANIZATION'S PLANNING AND COMMUNITY HEALTH EFFORTS.
PART VI, LINE 5:VERNON HEALTH CARRIES OUT ITS MISSION BY PROVIDING A COMPREHENSIVE RANGE OF OUTPATIENT AND INPATIENT MEDICAL SERVICES TO THE COMMUNITIES IT SERVES WITHOUT DISCRIMINATION BASED ON SEXUAL ORIENTATION, RACE, COLOR, CREED, RELIGION, AGE, DISABILITY, OR NATIONAL ORIGIN. THE ORGANIZATION OPERATES A 24/7 EMERGENCY DEPARTMENT THAT PROVIDES CARE TO ALL INDIVIDUALS, REGARDLESS OF THEIR ABILITY TO PAY, ENSURING ACCESS TO ESSENTIAL EMERGENCY SERVICES FOR THE REGION.VERNON HEALTH OWNS AND OPERATES FOUR RURAL HEALTH CLINICS LOCATED IN VIROQUA, WESTBY, SOLDIERS GROVE, AND LAFARGE, AS WELL AS FOUR RETAIL PHARMACIES SERVING THE COMMUNITIES OF VIROQUA, WESTBY, LAFARGE, AND SOLDIERS GROVE. THESE FACILITIES HELP PROMOTE COMMUNITY HEALTH BY OFFERING CONVENIENT ACCESS TO PRIMARY CARE AND PHARMACY SERVICES CLOSE TO HOME.THE ORGANIZATION WORKS CLOSELY WITH LOCAL COMMUNITIES, CHURCHES, BUSINESSES, AND OTHER HEALTHCARE PARTNERS TO IMPROVE ACCESS TO HIGH-QUALITY CARE AND ADDRESS LOCAL HEALTH NEEDS. OVERSIGHT IS PROVIDED BY AN INDEPENDENT BOARD OF DIRECTORS MADE UP OF COMMUNITY MEMBERS FROM ACROSS THE SERVICE AREA, ENSURING DECISIONS REFLECT LOCAL PRIORITIES.VERNON HEALTH MAINTAINS AN OPEN AND QUALIFIED MEDICAL STAFF, WITH PHYSICIANS COLLABORATING CLOSELY WITH HOSPITAL LEADERSHIP TO DELIVER SAFE, HIGH-QUALITY CARE. ALL PHYSICIANS AND AFFILIATED STAFF COMPLETE A THOROUGH CREDENTIALING AND ORIENTATION PROCESS TO MEET PROFESSIONAL AND ORGANIZATIONAL STANDARDS.ANY SURPLUS FUNDS GENERATED FROM OPERATIONS ARE REINVESTED INTO FACILITIES, EQUIPMENT, AND THE EXPANSION OF ESSENTIAL SERVICES, ALLOWING VERNON HEALTH TO CONTINUE MEETING THE EVOLVING HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES.
PART VI, LINE 7, REPORTS FILED WITH STATESWI

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDesc
VERNON MEMORIAL HEALTHCARE FOUNDATION INC
507 S MAIN STVIROQUAWI54665391515716501(C)(3)$35,962$0OPERATIONS SUPPORT
WESTERN TECHNICAL COLLEGE
400 7TH STREET NORTHLA CROSSEWI54601396002842GOV'T ORGANIZATION$0$14,574EDUCATION SUPPORTFAIR MARKET VALUEEDUCATION EQUIPMENT
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPSGrantTypeTxt
Recipient12RecipientCnt
Cash Grant$49,483CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationCHARITABLE CONTRIBUTIONS MADE BY VERNON MEMORIAL HEALTHCARE (CMH) WILL BE LIMITED TO ELIGIBLE ORGANIZATIONS THAT SET FORWARD A FUNDING REQUEST THAT DEMONSTRATE AN ALIGNMENT WITH THE VMH MISSION, VMH VISION AND VALUES, AND/OR TARGETED TO SUPPORT A NEED SET FORWARD IN THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE COMMUNITIES SERVED BY VMN. ALL ELIGIBLE ORGANIZATIONS MUST BE RECOGNIZED AS A 501(C)(3) ENTITY BY THE INTERNAL REVENUE SERVICE. THE MARKETING MANAGER IS RESPONSIBLE FOR EVALUATION OF ALL APPLICATIONS TO DETERMINE ALIGNMENT WITH THIS POLICY AND TO ENSURE THAT VMH MAINTAINS APPROPRIATE OVERALL FISCAL CONTROL ON EXPENDITURE OF COMMUNITY SUPPORT FUNDS. IT IS HER/HIS INDIVIDUAL AUTHORITY TO DENY ANY REQUEST THAT DOES NOT MEET ESTABLISHED CRITERIA OR THAT IS NOT IN ALIGNMENT WITH THE VMH FISCAL NEEDS AND SHE/HE HAS FINAL AUTHORITY FOR THAT DECISION. FOR THOSE APPLICATIONS DEEMED TO MEET THE CRITERIA OF THIS POLICY, THE FOLLOWING TABLE HIGHLIGHTS AUTHORITY LIMITS: MARKETING MANAGER -$5,000 AND BELOW -AND ONE-TIME DONATION -AND TOTAL ANNUAL COMMITMENT REMAINS AT OR BELOW BUDGET CEO -$5,001 AND UP -AND ONE-TIME DONATION -AND TOTAL ANNUAL COMMITMENT REMAINS AT OR BELOW BUDGET BOARD OF DIRECTORS -DONATIONS CAUSE THE ENTITY TO EXCEED THE ANNUAL APPROVED BUDGET VALUE -AND/OR ALL MULTI-YEAR COMMITMENTSExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DEBORAH PRIOR
ER PHYSICIAN$552,663$0$938$0$360$0$18,405$0$21,393$0$593,759$0$0$0
JEFFREY SCHEIDT
CRNA$441,470$0$1,101$0$360$0$14,773$0$27,732$0$485,436$0$0$0
DAVID HARTBERG
CEO$397,001$0$17,454$0$22,601$0$14,295$0$26,655$0$478,006$0$0$0
ADAM WUENSCH
ER PHYSICIAN$413,239$0$805$0$9,537$0$578$0$27,732$0$451,891$0$0$0
MITCHELL WILKINS
CRNA$318,676$0$5,657$0$3,355$0$0$0$9,585$0$337,273$0$0$0
SCOTT LECKEY
CFO$290,232$0$6,401$0$360$0$5,367$0$18,732$0$321,092$0$0$0
KRISTY WILTROUT
FORMER CNO$168,856$0$7,514$0$112,604$0$6,551$0$14,150$0$309,675$0$0$0
ROBERT LOVEJOY
COO$245,138$0$5,255$0$360$0$10,077$0$21,843$0$282,673$0$0$0
KENNETH HALLWOOD
CRNA$159,080$0$10,233$0$120$0$637$0$3,055$0$173,125$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4AKRISTY WILTROUT, FORMER CNO, RECEIVED A SEVERANCE PAYMENT DURING CALENDAR YEAR 2024 OF $77,069.
PART I, LINE 7THE ORGANIZATION MAINTAINS AN ANNUAL INCENTIVE COMPENSATION PROGRAM FOR EMPLOYEES, INCLUDING CERTAIN EXECUTIVES, UNDER WHICH AWARDS ARE PAID BASED ON THE ACHIEVEMENT OF SPECIFIED ORGANIZATIONAL FINANCIAL PERFORMANCE GOALS. THE FINANCIAL GOALS ARE BASED ON THE BUDGETED NET OPERATING INCOME. PERFORMANCE IMPACTS THAT TOTAL REWARD PAID. BONUS/INCENTIVE PAYMENTS DURING CALENDAR YEAR 2024: - DAVID HARTBERG $17,454 - SCOTT LECKEY $6,401 - ROBERT LOVEJOY $5,255 - KRISTY WILTROUT $7,514 - DEBORAH PRIOR $938 - ADAM WUENSCH $805 - JEFFREY SCHEIDT $1,101 - MITCHEL WILKINS $5,657 - KENNETH HALLWOOD $10,233

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN391337855BondIssuerEIN
CUSIP97712DGX8CUSIPNum
Bond Issued2014-12-09BondIssuedDt
Issue Price$19,445,225IssuePriceAmt
PurposeREFINANCE 2005 BONDSPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$8,175,225RetiredAmt
Total Proceeds$19,445,225TotalProceedsAmt
Issuance Costs From Proceeds$286,481IssuanceCostsFromProceedsAmt
Other Spent Proceeds$19,158,744OtherSpentProceedsAmt
Substantial Completion2006SubstantialCompletionYr
Refunding Tax Exempt BondsYes (1)RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate DueYes (1)NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceDATE REBATE COMPUTATION PERFORMEDFormAndLineReferenceDesc
ExplanationISSUER NAME: WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 12/05/2024ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 HERETOFORE OR MAY HEREAFTER CONTRIBUTE TEN DOLLARS OR MORE TO VERNON MEMORIAL HEALTHCARE, INC. (THE ORGANIZATION") SHALL BE A MEMBER THEREOF. ALL MEMBERS OF THE ORGANIZATION SHALL BE VOTING MEMBERS. EACH MEMBER SHALL HAVE ONE VOTE ON ANY MATTER SUBMITTED TO A VOTE OF THE MEMBERS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE DUTIES OF THE MEMBERS OF THE ORGANIZATION SHALL BE: THE ELECTION OF MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION, THE REMOVAL OF MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION, AND THE CHANGING OF THE NUMBER OF DIRECTORS CONSTITUTING THE BOARD OF DIRECTORS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7BTHE DUTIES OF THE MEMBERS OF THE VERNON ORGANIZATION SHALL ALSO INCLUDE: THE AMENDMENT, RESTATEMENT, OR MODIFICATION OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE ORGANIZATION; AND THE APPROVAL OF THE SALE, LEASE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL OF THE ASSETS AND PROPERTY OF THE ORGANIZATION, THE DISSOLUTION OF THE ORGANIZATION, OR ITS MERGER WITH ANOTHER CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS OF VERNON MEMORIAL HEALTHCARE, INC. FOR REVIEW AFTER FILING THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12CALL 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 15TO DETERMINE APPROPRIATE SALARY RANGES FOR UPPER MANAGEMENT POSITIONS, VERNON MEMORIAL HEALTHCARE, INC. UTILIZES BENCHMARK DATA FROM SURVEYS CONDUCTED BY RELEVANT TRADE ORGANIZATIONS. THE CEO HAS THE RIGHT TO AMEND THE AMOUNT DETERMINED FOR THE CFO. THE BOARD HAS THE RIGHT TO AMEND THE AMOUNT FOR THE CEO. A 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.
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 CANDID.
FORM 990, PART XI, LINE 2C:OVERSIGHT OF AUDIT: VERNON 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.

Schedule R IRS990ScheduleR

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1VERNON MEMORIALGUNDERSEN LUTHERAN MEDICAL BUILDING CONDOMINIUM ASSOC LTDBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1507 S MAIN STAddressLine1Txt
CityVIROQUACityNm
State AbbreviationWIStateAbbreviationCd
ZIP54665ZIPCd
FieldValueIRS element (for citing)
EIN320182492EIN
Primary ActivitiesPROPERTY MANAGEMENTPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Ownership0.50000OwnershipPct
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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