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VERNON MEMORIAL HEALTHCARE INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
VERNON MEMORIAL HEALTHCARE INC (EIN 39-0806404)
Tax period
2022-10-01 to 2023-09-30
Filed
2024-08-14
IRS object ID
202412279349301796
Schema version
2022v5.0
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)
Return2024-08-14T15:00:00-05:00ReturnTs
Tax Period End2023-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11502 LONDON ROAD SUITE 200AddressLine1Txt
CityDULUTHCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55812ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-10-01TaxPeriodBeginDt

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
Signature2024-08-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHAEL J PETERSON CPAPreparerPersonNm
PTINP01833529PTIN
Phone2187224705PhoneNum
Preparation2024-07-22PreparationDt
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2024-08-08 14:25:15ZBuildTS

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$87,977,040GrossReceiptsAmt
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. WILL STRIVE TO HAVE THE VISION TO CONTINUALLY PROVIDE THE HIGHEST STANDARD OF CARE TO OUR PATIENTS AND THEIR FAMILIES WHILE BEING 'CLOSE TO HOME.' OUR MISSION AFFIRMS OUR COMMITMENT TO BEING THE BEST COMMUNITY HEALTHCARE SYSTEM IN THE REGION. IN SUPPORT OF THIS MISSION, WE CONSIDER IT ESSENTIAL TO PROVIDE COST-EFFECTIVE, ACCESSIBLE CARE AND SERVICES USING PROFESSIONAL TREATMENT TO THE INJURED, AFFLICTED, AND WELL PEOPLE WHO NEED THE RESOURCES WE HAVE AT OUR COMMAND, WITHOUT REGARD TO RACE, CREED, COLOR, SEX, HANDICAP, NATIONAL ORIGIN, OR ABILITY TO PAY. IT IS OUR INTENTION TO ENSURE THAT IN EACH AND EVERY CASE OUR PATIENTS SHALL BE TREATED WITH COMPASSION, UNDERSTANDING AND DIGNITY. FURTHER, THE RIGHTS AND PRIVILEGES OF THE PEOPLE WE SERVE SHALL ALWAYS BE HELD IN THE HIGHEST REGARD, AND THEIR WELL-BEING MUST ALWAYS HAVE FIRST CONSIDERATION.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee555TotalEmployeeCnt
Total Volunteers70TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,874,685PYContributionsGrantsAmt
CY Contributions Grants$426,133CYContributionsGrantsAmt
PY Program Service Revenue$78,247,220PYProgramServiceRevenueAmt
CY Program Service Revenue$85,776,281CYProgramServiceRevenueAmt
PY Investment Income$1,893,553PYInvestmentIncomeAmt
CY Investment Income$1,326,435CYInvestmentIncomeAmt
PY Other Revenue$293,353PYOtherRevenueAmt
CY Other Revenue$300,947CYOtherRevenueAmt
PY Total Revenue$83,308,811PYTotalRevenueAmt
CY Total Revenue$87,829,796CYTotalRevenueAmt
PY Grants And Similar Paid$11,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$68,822CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$38,451,653PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$43,034,439CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$36,428,388PYOtherExpensesAmt
CY Other Expenses$38,953,365CYOtherExpensesAmt
PY Total Expenses$74,891,041PYTotalExpensesAmt
CY Total Expenses$82,056,626CYTotalExpensesAmt
PY Revenues Less Expenses$8,417,770PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,773,170CYRevenuesLessExpensesAmt
Total Assets BOY$118,795,661TotalAssetsBOYAmt
Total Assets EOY$122,283,417TotalAssetsEOYAmt
Total Liabilities BOY$28,774,528TotalLiabilitiesBOYAmt
Total Liabilities EOY$22,716,357TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$90,021,133NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$99,567,060NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWE ARE COMMITTED TO BEING THE BEST COMMUNITY HEALTHCARE SYSTEM IN THE REGION.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$56,924,955ExpenseAmt
Grant$68,822GrantAmt
Revenue$76,265,385RevenueAmt
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 EXEMPLIFY 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 2023 INCLUDED 2,127 ADULT AND PEDIATRIC INPATIENT DAYS AND 117 NEWBORN DELIVERIES. THERE WAS A TOTAL OF 1,979 SURGERY CASES (INPATIENT AND OUTPATIENT COMBINED) AND THERE WERE 96,617 TOTAL OUTPATIENT VISITS. THE VMH EMERGENCY ROOM PROVIDED IMMEDIATE ACCESS TO CARE IN RESPONSE TO 8,164 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 THE 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$12,966,621ExpenseAmt
Grant$0GrantAmt
Revenue$9,510,896RevenueAmt
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 36,006 RURAL HEALTH CLINIC VISITS OCCURRED IN FISCAL YEAR 2023. 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$69,891,576TotalProgramServiceExpensesAmt
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 Assets0ReportOtherAssetsInd
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 Individuals0GrantsToIndividualsInd
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 Document102IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee555EmployeeCnt
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 Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
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 (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
TOM WESTON
CHAIR1.00Yes (X)Yes (X)$0$0$0
PETER HUGHES
VICE CHAIR1.00Yes (X)Yes (X)$0$0$0
PAUL LARSEN
TREASURER1.00Yes (X)Yes (X)$0$0$0
VICKI ANDERSON
SECRETARY1.00Yes (X)Yes (X)$0$0$0
MARILYN CLAUSON
MEMBER (THRU 12/2022)1.00Yes (X)$0$0$0
MARY GAJEWSKI
MEMBER (THRU 12/2022)1.00Yes (X)$0$0$0
MELISSA HUGHES
MEMBER (THRU 03/2023)1.00Yes (X)$0$0$0
STACY KRING
MEMBER1.00Yes (X)$0$0$0
STEVE MICHAELS
MEMBER1.00Yes (X)$0$0$0
DORI MICKELSON
MEMBER1.00Yes (X)$0$0$0
JOAN PETERSON
MEMBER1.00Yes (X)$0$0$0
KIMBERLY TURNMIRE
MEMBER1.00Yes (X)$0$0$0
PAUL WOODWARD
MEMBER1.00Yes (X)$0$0$0
ROBERT LOVEJOY
COO40.00Yes (X)$197,324$0$25,707
KRISTY WILTROUT
CNO40.00Yes (X)$224,680$0$26,317
SCOTT LECKEY
CFO40.00Yes (X)$252,613$0$18,248
DAVID HARTBERG
CEO40.00Yes (X)$407,210$0$14,819
ANDREW MANSPEAKER
ER PHYSICIAN30.00$454,901$0$37,213Yes (X)
JEFFREY SCHEIDT
CRNA40.00$400,369$0$38,958Yes (X)
BRIAN MILLER
CRNA40.00$395,149$0$39,457Yes (X)
SHAWN SEDGWICK
ER PHYSICIAN40.00$395,992$0$28,192Yes (X)
BRENDAN SOTOMAYOR
ER PHYSICIAN30.00$311,786$0$5,167Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,040,024TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$234,078TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K81IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
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
BURLINGTON HEALTHCARE PROVIDER
W329 N4476 LAKELAND DRIVE SUITE 14NASHOTAWI53058STAFFING SERVICES$945,002
WAPITI
100 FLYNN DRIVE SUITE 600MILBANKSD57252STAFFING SERVICES$458,879
CROSS COUNTRY STAFFING
PO BOX 404674ATLANTAGA30384STAFFING SERVICES$380,415
CURATIVE TALENT
PO BOX 122549DALLASTX753122549STAFFING SERVICES$260,006
AMN HEALTH
2735 COLLECTION CENTER DRIVECHICAGOIL60693STAFFING SERVICES$239,621
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K12CntrctRcvdGreaterThan100KCnt
Government Grants$269,599GovernmentGrantsAmt
All Other Contributions$156,534AllOtherContributionsAmt
Noncash Contributions$10,400NoncashContributionsAmt
Total Contributions$426,133TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
HOSPITAL621990$66,537,457$66,537,457
RETAIL PHARMACY456110$9,727,928$9,727,928
CLINIC621110$9,510,896$9,510,896
FieldValueIRS element (for citing)
Total Program Service Revenue$85,776,281TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,473,679TotalRevenueColumnAmt
Exclusion$1,473,679ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$300,947RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$300,947RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$300,947TotalRevenueColumnAmt
Exclusion$300,947ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$127,934SecuritiesAmt
Other$19,310OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$127,934SecuritiesAmt
Other-$19,310OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$147,244TotalRevenueColumnAmt
Exclusion-$147,244ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$87,829,796TotalRevenueColumnAmt
Related Or Exempt Func Income$85,776,281RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,627,382ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$64,822TotalAmt
Program Services$64,822ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$4,000TotalAmt
Program Services$4,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,230,277TotalAmt
Program Services$503,154ProgramServicesAmt
Management And General$727,123ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$32,954,768TotalAmt
Program Services$27,689,135ProgramServicesAmt
Management And General$5,265,633ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$965,044TotalAmt
Program Services$860,209ProgramServicesAmt
Management And General$104,835ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,599,337TotalAmt
Program Services$4,924,773ProgramServicesAmt
Management And General$674,564ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,285,013TotalAmt
Program Services$2,003,705ProgramServicesAmt
Management And General$281,308ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$232,833TotalAmt
Management And General$232,833ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$3,500TotalAmt
Management And General$3,500ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$5,453TotalAmt
Management And General$5,453ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$43,690TotalAmt
Management And General$43,690ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,092,850TotalAmt
Program Services$6,544,209ProgramServicesAmt
Management And General$548,641ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$228,096TotalAmt
Program Services$209,472ProgramServicesAmt
Management And General$18,624ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$304,451TotalAmt
Program Services$166,701ProgramServicesAmt
Management And General$137,750ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$803,547TotalAmt
Management And General$803,547ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,775,598TotalAmt
Program Services$630,950ProgramServicesAmt
Management And General$1,144,648ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$72,333TotalAmt
Program Services$38,494ProgramServicesAmt
Management And General$33,839ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$235,217TotalAmt
Program Services$193,873ProgramServicesAmt
Management And General$41,344ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$570,695TotalAmt
Program Services$474,581ProgramServicesAmt
Management And General$96,114ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,468,719TotalAmt
Program Services$3,716,118ProgramServicesAmt
Management And General$752,601ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$325,179TotalAmt
Program Services$35,250ProgramServicesAmt
Management And General$289,929ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PHARMACEUTICALS$9,683,118$9,683,118
SUPPLIES$6,828,944$6,803,393$25,551
BAD DEBT EXPENSE$3,562,463$3,562,463
EQUIPMENT RENTAL & MAIN$1,628,588$1,520,850$107,738

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,088,091TotalAmt
Program Services$262,306ProgramServicesAmt
Management And General$825,785ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$82,056,626TotalAmt
Program Services$69,891,576ProgramServicesAmt
Management And General$12,165,050ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$13,313,575BOYAmt
EOY$7,862,189EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$17,550,728BOYAmt
EOY$15,874,626EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$163,515BOYAmt
EOY$235,025EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,731,304BOYAmt
EOY$7,799,199EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,232,761BOYAmt
EOY$3,198,767EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$407,272BOYAmt
EOY$331,326EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$95,251,822LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$58,359,414LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$36,782,010BOYAmt
EOY$36,892,408EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$37,060,168BOYAmt
EOY$46,469,901EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$108,422BOYAmt
EOY$113,820EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,445,906BOYAmt
EOY$3,506,156EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$118,795,661BOYAmt
EOY$122,283,417EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,164,143BOYAmt
EOY$6,167,147EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$5,146,863BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,431,661BOYAmt
EOY$13,503,257EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,031,861BOYAmt
EOY$3,045,953EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$28,774,528BOYAmt
EOY$22,716,357EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$89,857,618BOYAmt
EOY$99,332,035EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$163,515BOYAmt
EOY$235,025EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$90,021,133BOYAmt
EOY$99,567,060EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$118,795,661BOYAmt
EOY$122,283,417EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$5,773,170ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$3,772,757NetUnrlzdGainsLossesInvstAmt
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 RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

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$5,453OtherActivitiesAmt
Total Lobbying Expenditures$5,453TotalLobbyingExpendituresAmt
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$1,497,208OtherCostOrOtherBasisAmt
Book Value$1,497,208BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$64,876,949OtherCostOrOtherBasisAmt
Depreciation$37,735,334DepreciationAmt
Book Value$27,141,615BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$27,960,997OtherCostOrOtherBasisAmt
Depreciation$20,624,080DepreciationAmt
Book Value$7,336,917BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$916,668OtherCostOrOtherBasisAmt
Book Value$916,668BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$36,892,408TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DEFERRED COMPENSATION PLAN LIABILITY - FUNDED$2,315,953
MEDICAL CLAIMS PAYABLE$730,000
FieldValueIRS element (for citing)
Total Liability$3,045,953TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$87,921,550TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$3,772,757NetUnrealizedGainsInvstAmt
Other Revenue-$3,565,803OtherRevenueAmt
Revenue Not Reported$206,954RevenueNotReportedAmt
Revenue Subtotal$87,714,596RevenueSubtotalAmt
Investment Expenses Not Incld$43,690InvestmentExpensesNotIncldAmt
Other Revenues Not Included$71,510OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$115,200RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$87,829,796TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$78,447,133TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$78,447,133ExpensesSubtotalAmt
Investment Expenses Not Incld2$43,690InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$3,565,803OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$3,609,493ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$82,056,626TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:WELLNESS CENTER EXPENSE -3,340. BAD DEBT EXPENSE NET AGAINST REVENUE -3,562,463.
PART XI, LINE 4B - OTHER ADJUSTMENTS:CONTRIBUTIONS TO RESTRICTED NET ASSETS 154,368. NET ASSETS RELEASED FROM RESTRICTIONS -82,858.
PART XII, LINE 4B - OTHER ADJUSTMENTS:WELLNESS CENTER EXPENSE 3,340. BAD DEBT EXPENSE NET AGAINST REVENUE 3,562,463.

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$858,093TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$858,093NetCommunityBenefitExpnsAmt
Total Expense0.01090TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,860,538TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,663,526DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,197,012NetCommunityBenefitExpnsAmt
Total Expense0.02800TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,718,631TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,663,526DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,055,105NetCommunityBenefitExpnsAmt
Total Expense0.03890TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$129,769TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,950DirectOffsettingRevenueAmt
Net Community Benefit Expns$124,819NetCommunityBenefitExpnsAmt
Total Expense0.00160TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$765,429TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$765,429NetCommunityBenefitExpnsAmt
Total Expense0.00980TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,995,563TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,463,727DirectOffsettingRevenueAmt
Net Community Benefit Expns$531,836NetCommunityBenefitExpnsAmt
Total Expense0.00680TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$66,656TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$66,656NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,957,417TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,468,677DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,488,740NetCommunityBenefitExpnsAmt
Total Expense0.01900TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,676,048TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,132,203DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,543,845NetCommunityBenefitExpnsAmt
Total Expense0.05790TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,742TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,742NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,742TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,742NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$1,568,723BadDebtExpenseAmt
Bad Debt Expense Attributable$784,362BadDebtExpenseAttributableAmt
Reimbursed By Medicare$14,256,770ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$14,305,407CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$48,637MedicareSurplusOrShortfallAmt

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 Conducted20CHNAConductedYr
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 Adpt20ImplementationStrategyAdptYr
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
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
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 URLHTTPS://WWW.VMH.ORG/MEDIA/IMKNGPCC/FAP-POLICY-6-2022.PDFFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://WWW.VMH.ORG/MEDIA/20MLXWEK/2022-FAP-APPLICATION.PDFFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://WWW.VMH.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FAPSummaryOnWebsiteURLTxt
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 (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 3J: 1. USE OF EPIC ELECTRONIC HEALTH RECORD'S POPULATION HEALTH MANAGEMENT MODULE FOR MONITORING PROCESSES. 2. DIABETIC EDUCATION PROGRAM OFFERS PATIENTS EDUCATION AND SUPPORT ON MANAGING DIABETES AND SUPPORTS OVERALL HEALTH. 3. CARE COORDINATION PROGRAM, WHICH OFFERS SOCIAL WORK SUPPORT TO ASSIST PATIENTS IN REACHING THEIR OPTIMAL HEALTH. 4. PARTNERSHIP WITH VERNON COUNTY PARTNERSHIP COUNCIL, WHICH EXISTS TO DEVELOP AND SUPPORT PROGRAMMING THAT ADDRESSES DRUG, ALCOHOL, AND TOBACCO CONCERNS. 5. VMH OFFERS MENTAL HEALTH SERVICES THROUGH THREE LICENSED CLINICAL SOCIAL WORKERS AND ONE PSYCHIATRIST, WHO ALSO OFFERS CHILD AND ADOLESCENT PSYCHIATRY. WE ARE CURRENTLY RECRUITING ADDITIONAL STAFF.
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 5: DATA WAS COLLECTED BY RANDOM HOUSEHOLD SURVEY TO 6,000 HOUSEHOLDS AND WAS STRATIFIED BY COUNTY TO ASSURE THAT EVERY JURISDICTION WOULD BE REPRESENTED. IN ADDITION, A SUPPLEMENTAL CONVENIENCE SURVEY WAS CONDUCTED TO GENERATE SURVEY RESPONSES FROM POPULATIONS THAT MAY HAVE BEEN UNDER-REPRESENTED IN THE RANDOM HOUSEHOLD SURVEY.
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 6A: THE COMPASS NOW 2021 PARTNERSHIP WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS:1. GUNDERSEN HEALTH SYSTEM, LA CROSSE2. MAYO CLINIC HEALTH SYSTEM, LA CROSSE3. 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 2021 PARTNERSHIP WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING ORGANIZATIONS:1. GREAT RIVERS UNITED WAY2. TREMPEALEAU COUNTY HEALTH DEPARTMENT3. MONROE COUNTY HEALTH DEPARTMENT4. GUNDERSEN HEALTH SYSTEM, LA CROSSE, AS WELL AS GUNDERSEN ST. JOSEPH'S HOSPITAL AND CLINICS IN HILLSBORO AND GUNDERSEN TRI-COUNTY HOSPITAL AND CLINICS IN WHITEHALL5. VERNON COUNTY HEALTH DEPARTMENT6. APTIV, INC.7. LA CROSSE COUNTY HEALTH DEPARTMENT8. BUFFALO COUNTY HEALTH DEPARTMENT9. HOUSTON COUNTY HEALTH DEPARTMENT (MINNESOTA)10. COULEECAP11. MAYO CLINIC HEALTH SYSTEM IN BOTH LA CROSSE AND SPARTA 12. LA CROSSE COUNTY HUMAN SERVICES
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 7D: PART V, LINE 7A:HTTPS://WWW.GREATRIVERSUNITEDWAY.ORG/WP-CONTENT/UPLOADS/2021/06/2021-COMPASS-NOW-REPORT_FINAL-WEB.PDFPART V, LINE 7B:HTTPS://WWW.GREATRIVERSUNITEDWAY.ORG/OUR-WORK/COMMUNITY-NEEDS-ASSESSMENT/COMPASS-NOW-REPORT-2021/PART V, LINE 10A:HTTPS://WWW.GREATRIVERSUNITEDWAY.ORG/WP-CONTENT/UPLOADS/2021/06/2021-COMPASS-NOW-REPORT_FINAL-WEB.PDF
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 11: THREE OF THE KEY ISSUES IDENTIFIED FOR VERNON COUNTY IN THE 2021 COMPASS NOW CHNA INCLUDE: 1. MENTAL HEALTH, 2. POVERTY/LIVABLE WAGES, 3. CHILDCARE. INCREASED ACCESS TO MENTAL HEALTHCARE SERVICES:ACCORDING TO THE 2021 COMMUNITY HEALTHCARE NEEDS ASSESSMENT, VERNON COUNTY FACES CHALLENGES IN ACCESSING HEALTHCARE SERVICES. SPECIFICALLY, 56% OF ADULTS AND 55% OF YOUTH IN THE COUNTY WHO REQUIRE TREATMENT ARE NOT RECEIVING IT. MOREOVER, 5% OF RESPONDENTS FROM THE RANDOM HOUSEHOLD SURVEY (RHS) AND 12% FROM THE CONVENIENCE SURVEY (CS) REPORTED INADEQUATE ACCESS TO MENTAL HEALTH CARE.TO ADDRESS THESE ISSUES, VMH IS EXPANDING ITS BEHAVIORAL HEALTH SERVICES AND SEEKING COLLABORATION WITH LOCAL ORGANIZATIONS TO ENHANCE PATIENT ACCESS WITHIN ITS SERVICE AREA. VMH HAS BOLSTERED ITS BEHAVIORAL HEALTH STAFF AND IS EXPLORING PARTNERSHIPS WITH NEIGHBORING HEALTHCARE PROVIDERS TO OPTIMIZE RESOURCE UTILIZATION AND PROMOTE AWARENESS OF AVAILABLE SERVICES.CURRENTLY, VMH IS WORKING IN CONJUNCTION WITH THE MEDICAL COLLEGE OF WISCONSIN, INC. TO DELIVER CONSULTATIVE CHILD AND ADOLESCENT PSYCHIATRY SERVICES THROUGH THE MCW'S CHILD PSYCHIATRY CONSULTATION PROGRAM.POVERTY/FINANCIAL STABILITYAS PER THE 2021 COMMUNITY HEALTHCARE NEEDS ASSESSMENT, INDICATORS OF POVERTY OR FINANCIAL STABILITY AMONG VERNON COUNTY RESIDENTS INCLUDE:- 11% OF SURVEY PARTICIPANTS FROM VERNON COUNTY REPORT BEING UNINSURED.- 46% OF SURVEY PARTICIPANTS FROM VERNON COUNTY REPORT AN ANNUAL HOUSEHOLD INCOME OF LESS THAN $50,000, WITH 23% REPORTING AN INCOME OF LESS THAN $25,000 PER YEAR.IN THE FISCAL YEAR 2023, VMH CONTINUES TO APPRISE PATIENTS OF AVAILABLE FINANCIAL ASSISTANCE AND CHARITY CARE OPTIONS WHEN THEY UTILIZE HEALTHCARE SERVICES AT VERNON MEMORIAL HEALTHCARE. INFORMATION REGARDING FINANCIAL AID IS DISSEMINATED AT PATIENT REGISTRATION DESKS, VERBALLY COMMUNICATED UPON CHECK-IN, DURING BILLING STATEMENT ISSUANCE, AND THROUGHOUT BILLING INTERACTIONS POST-TREATMENT. THIS INFORMATION IS ALSO ACCESSIBLE ON THE VERNON MEMORIAL HEALTHCARE WEBSITE. MOREOVER, VMH COLLABORATES WITH LOCAL ORGANIZATIONS TO EDUCATE PATIENTS ON AVAILABLE RESOURCES AND PROGRAMS FOR FINANCIAL AID, INCLUDING REFERRALS TO VERNON COUNTY FOR SERVICES SUCH AS HEATING AND FOOD ASSISTANCE, AS WELL AS COPAYMENT SUPPORT FOR MEDICARE PATIENTS.VMH IS COMMITTED TO ENHANCING PUBLIC AWARENESS OF COMMUNITY RESOURCES BENEFICIAL TO FINANCIALLY STRUGGLING FAMILIES, SUCH AS FOOD BANKS AND FREE VACCINE CLINICS. TO ACHIEVE THIS, VERNON MEMORIAL HEALTHCARE IS IMPLEMENTING THE FOLLOWING STRATEGIES FOR RESOURCE DISSEMINATION:- POSTING ON FACEBOOK- DISTRIBUTING PRINTED MATERIALS- PROVIDING WEBSITE LINKS- FACILITATING INTERACTION WITH SOCIAL WORKERSCHILDCAREACCORDING TO THE 2021 COMMUNITY HEALTHCARE NEEDS ASSESSMENT, 10% OF RANDOM HOUSEHOLD SURVEY (RHS) RESPONDENTS AND 22% OF CONVENIENCE SURVEY (CS) RESPONDENTS EXPRESS EITHER "MODERATE OR "HIGH" LEVELS OF CONCERN REGARDING ACCESS TO CHILDCARE.VERNON MEMORIAL HEALTHCARE IS COMMITTED TO COLLABORATING WITH ECONOMIC, EDUCATIONAL, AND COMMUNITY LEADERS TO ADDRESS THE CHILDCARE NEEDS IN THE AREA AND PROVIDE SUPPORT. ADDITIONALLY, THROUGH PARTNERSHIPS WITH CHAMBERS OF COMMERCE, SCHOOL DISTRICTS, AND OTHER RELEVANT ORGANIZATIONS, VERNON MEMORIAL HEALTHCARE WILL ASSIST IN INITIATIVES AIMED AT INCREASING CHILDCARE OPTIONS LOCALLY.IN DECEMBER 2021, VMH SOLD ONE OF ITS COMMUNITY-BASED RESIDENTIAL FACILITY (CBRF) BUILDINGS TO THE VIROQUA SCHOOL DISTRICT AT A FINANCIAL LOSS. SUBSEQUENTLY, THE SCHOOL DISTRICT REFURBISHED THE FACILITY TO ACCOMMODATE CHILDCARE SERVICES, WHICH ARE NOW ACCESSIBLE TO CHILDREN AGED 6 WEEKS TO 11 YEARS OLD.
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
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 $ 3,562,463.
PART II, COMMUNITY BUILDING ACTIVITIES:OUR HOSPITAL PROVIDES CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. BUT IN ADDITION, WE BELIEVE THAT WE PROVIDE A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. OUR HOSPITAL, LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE LOCAL ACCESS TO MANY HEALTH SERVICES: BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES AND URGENT CARE, HOME CARE, HOSPICE, INFUSION SERVICES, INPATIENT CARE, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SPEECH AND AUDIOLOGY, SURGICAL SERVICES, AND WOMEN'S HEALTH.
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 MEMORIAL HEALTHCARE UTILIZES A RANGE OF STRATEGIES TO GATHER AND ASSESS DATA PERTAINING TO THE NEEDS OF THE COMMUNITIES IT SERVES. IN ADDITION TO THE FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED IN COLLABORATION WITH NEIGHBORING HEALTHCARE FACILITIES, THE GREAT RIVERS UNITED WAY, AND COUNTY HEALTH DEPARTMENTS, THE ORGANIZATION EMPLOYS INFORMAL METHODS SUCH AS FOCUS AND ADVISORY GROUPS, CONSULTATIONS WITH LOCAL EMPLOYERS, AND ONLINE SURVEYS. MOREOVER, ACTIVE PARTICIPATION IN LOCAL AND STATE BOARDS AND COMMITTEES ALLOWS THE ORGANIZATION TO STAY ABREAST OF COMMUNITY NEEDS. COLLABORATION WITH VARIOUS COMMUNITY ENTITIES INCLUDING ORGANIZATIONS, CHURCHES, BUSINESSES, AGENCIES, AND SCHOOLS IS ANOTHER AVENUE FOR GAUGING COMMUNITY NEEDS. THE ORGANIZATION'S BOARD MEMBERS, REPRESENTING DIVERSE AREAS SERVED, REGULARLY ENGAGE WITH COMMUNITY MEMBERS TO SOLICIT FEEDBACK ON THE ORGANIZATION'S SERVICES AND ADDRESS COMMUNITY CONCERNS. SOCIAL MEDIA ANALYTICS AND ONLINE TRENDS ARE ALSO ANALYZED TO GLEAN FURTHER INSIGHTS INTO COMMUNITY NEEDS. FINALLY, PATIENT SURVEYS ARE DISTRIBUTED POST-VISIT TO GATHER INPUT ON THE QUALITY OF CARE PROVIDED.
PART VI, LINE 3:VERNON MEMORIAL HEALTHCARE EMPLOYS VARIOUS STRATEGIES TO GATHER AND ASSESS DATA REGARDING THE REQUIREMENTS OF THE COMMUNITIES IT SERVES. IN ADDITION TO CONDUCTING A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN COLLABORATION WITH NEIGHBORING HEALTHCARE FACILITIES, THE GREAT RIVERS UNITED WAY, AND COUNTY HEALTH DEPARTMENTS, THE ORGANIZATION UTILIZES INFORMAL APPROACHES SUCH AS FOCUS AND ADVISORY GROUPS, DISCUSSIONS WITH LOCAL EMPLOYERS, AND ONLINE SURVEYS. MOREOVER, IT REMAINS ENGAGED WITH COMMUNITY NEEDS BY PARTICIPATING IN LOCAL AND STATE BOARDS AND COMMITTEES. COLLABORATION WITH COMMUNITY ORGANIZATIONS, CHURCHES, BUSINESSES, AGENCIES, AND EDUCATIONAL INSTITUTIONS SERVES AS ANOTHER AVENUE FOR EVALUATING COMMUNITY NEEDS. THE ORGANIZATION'S BOARD MEMBERS, REPRESENTING DIVERSE AREAS SERVED, ACTIVELY ENGAGE WITH COMMUNITY MEMBERS TO COMPREHEND THEIR CONCERNS AND ACCESS THE ORGANIZATION'S SERVICES. ADDITIONALLY, INSIGHTS INTO COMMUNITY NEEDS ARE GLEANED THROUGH ANALYSIS OF SOCIAL MEDIA DATA AND ONLINE TRENDS. PATIENT FEEDBACK IS ALSO SOLICITED THROUGH POST-VISIT SURVEYS TO ASSESS THE QUALITY OF CARE RECEIVED.
PART VI, LINE 4:VERNON MEMORIAL HEALTHCARE DELIVERS MEDICAL SERVICES TO VIROQUA AND ITS NEIGHBORING REGIONS, ENCOMPASSING WESTBY, READSTOWN, SOLDIERS GROVE, CASHTON, AND LAFARGE. THE PRIMARY SERVICE AREA INCLUDES THESE MUNICIPALITIES AND THEIR ADJACENT RURAL LOCALES, CATERING TO A POPULATION OF APPROXIMATELY 28,000. EXTENDING TO DESOTO, FERRYVILLE, HILLSBORO, COON VALLEY, RICHLAND CENTER, GAYS MILLS, VIOLA, AND ONTARIO, THE SECONDARY SERVICE AREA WIDENS THE CATCHMENT TO ACCOMMODATE AN ADDITIONAL 25,000 INDIVIDUALS. CHARACTERIZED BY ITS RURAL LANDSCAPE, THE ENTIRE REGION EXHIBITS AN AGING DEMOGRAPHIC WITH RELATIVELY MODEST INCOME LEVELS.
PART VI, LINE 5:VERNON MEMORIAL HEALTHCARE IS DEDICATED TO DELIVERING A WIDE ARRAY OF OUTPATIENT AND INPATIENT MEDICAL SERVICES TO THE COMMUNITIES IT SERVES, WITHOUT DISCRIMINATION BASED ON GENDER ORIENTATION, RACE, COLOR, CREED, RELIGION, AGE, DISABILITY, OR NATIONAL ORIGIN. THEIR COMMITMENT EXTENDS TO OPERATING A 24/7 EMERGENCY ROOM THAT PROVIDES CARE TO ALL, IRRESPECTIVE OF THEIR FINANCIAL MEANS. ADDITIONALLY, THEY OWN AND MANAGE FOUR RURAL HEALTH CLINICS LOCATED IN VIROQUA, WESTBY, SOLDIERS GROVE, AND LAFARGE, ALONG WITH FOUR RETAIL PHARMACIES IN VIROQUA, WESTBY, LAFARGE, AND SOLDIERS GROVE. COLLABORATING WITH LOCAL COMMUNITIES, CHURCHES, BUSINESSES, AND OTHER HEALTHCARE ENTITIES, VERNON MEMORIAL HEALTHCARE AIMS TO ENHANCE THE ACCESSIBILITY OF TOP-NOTCH HEALTHCARE SERVICES. THEY SUPPORT LOCAL COMMUNITIES BY OFFERING CONVENIENT PRIMARY CARE AND PHARMACY SERVICES. THE BOARD OF DIRECTORS, COMPOSED OF INDEPENDENT COMMUNITY MEMBERS FROM THE SERVED AREAS, OVERSEES THE ORGANIZATION. THE MEDICAL TEAM AT VERNON MEMORIAL HEALTHCARE COMPRISES SKILLED PHYSICIANS WHO COLLABORATE CLOSELY WITH THE HOSPITAL TO DELIVER HIGH-QUALITY CARE TO THE SURROUNDING COMMUNITIES. ALL PHYSICIANS AND AFFILIATED STAFF UNDERGO A THOROUGH CREDENTIALING AND ORIENTATION PROCESS. ANY EXCESS FUNDS FROM OPERATIONS ARE REINVESTED IN NEW FACILITIES AND EQUIPMENT OR USED TO EXPAND ESSENTIAL SERVICES TO MEET THE EVOLVING NEEDS OF THE COMMUNITY.
PART VI, LINE 7, REPORTS FILED WITH STATESWI

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
VERNON MEMORIAL HEALTHCARE FOUNDATION INC
507 S MAIN STVIROQUAWI54665391515716501(C)(3)$46,922$0OPERATING SUPPORT
VIROQUA AREA FOUNDATION
PO BOX 262VIROQUAWI54665391603279501(C)(3)$10,000$0FIRE TRAINING TOWER PLEDGE PAYMENT
RESTORING HOPE TRANSPLANT HOUSE
7457 TERRACE AVEMIDDLETONWI53562204786829501(C)(3)$7,900$0OPERATING EXPENSES FOR TRANSPLANT HOUSE
FieldValueIRS element (for citing)
Total501c3 Org3Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

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 Payment0SeverancePaymentInd
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 Payments0AnyNonFixedPaymentsInd
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
ANDREW MANSPEAKER
ER PHYSICIAN$453,753$0$1,148$0$0$0$18,076$0$19,137$0$492,114$0$0$0
JEFFREY SCHEIDT
CRNA$399,180$0$1,189$0$0$0$12,681$0$26,277$0$439,327$0$0$0
BRIAN MILLER
CRNA$393,960$0$1,189$0$0$0$15,929$0$23,528$0$434,606$0$0$0
SHAWN SEDGWICK
ER PHYSICIAN$394,803$0$1,189$0$0$0$8,383$0$19,809$0$424,184$0$0$0
DAVID HARTBERG
CEO$364,115$0$43,095$0$0$0$14,589$0$230$0$422,029$0$0$0
BRENDAN SOTOMAYOR
ER PHYSICIAN$298,615$0$13,171$0$0$0$0$0$5,167$0$316,953$0$0$0
SCOTT LECKEY
CFO$251,424$0$1,189$0$0$0$915$0$17,333$0$270,861$0$0$0
KRISTY WILTROUT
CNO$223,491$0$1,189$0$0$0$9,077$0$17,240$0$250,997$0$0$0
ROBERT LOVEJOY
COO$196,158$0$1,166$0$0$0$5,682$0$20,025$0$223,031$0$0$0

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$6,240,225RetiredAmt
Total Proceeds$19,445,225TotalProceedsAmt
Issuance Costs From Proceeds$286,481IssuanceCostsFromProceedsAmt
Other Spent Proceeds$19,158,744OtherSpentProceedsAmt
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: 12/09/2019ExplanationTxt

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 DETERMINED AMOUNT 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 GUIDESTAR.
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
Share Of Total Income$657,772ShareOfTotalIncomeAmt
Share Of EOY Assets$52,148ShareOfEOYAssetsAmt
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 Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd