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SAUK PRAIRIE HEALTHCARE INC: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
SAUK PRAIRIE HEALTHCARE INC (EIN 39-0872080)
Tax period
2023-01-01 to 2023-12-31
Filed
2024-11-13
IRS object ID
202423189349306917
Schema version
2023v5.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-11-13T13:39:35-06:00ReturnTs
Tax Period End2023-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 S 6TH STREET SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390872080EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SAUK PRAIRIE HEALTHCARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSAUKBusinessNameControlTxt
Phone6086433311PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1260 26TH STREETAddressLine1Txt
CityPRAIRIE DU SACCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53578ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJAMES DREGNEYPersonNm
Person TitleCFOPersonTitleTxt
Phone6086433311PhoneNum
Signature2024-11-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonGREG THELENPreparerPersonNm
PTINP01771735PTIN
Phone6123764500PhoneNum
Preparation2024-11-11PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2024-10-15 13:58:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSHAWN LERCHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1260 26TH STREETAddressLine1Txt
CityPRAIRIE DU SACCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53578ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$127,362,751GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SAUKPRAIRIEHEALTHCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1956FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionEXTRAORDINARY HEALTHCARE FROM THE HEART - ONE PERSON AT A TIME.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee845TotalEmployeeCnt
Total Volunteers81TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$586,708PYContributionsGrantsAmt
CY Contributions Grants$125,396CYContributionsGrantsAmt
PY Program Service Revenue$110,499,651PYProgramServiceRevenueAmt
CY Program Service Revenue$120,326,207CYProgramServiceRevenueAmt
PY Investment Income$624,974PYInvestmentIncomeAmt
CY Investment Income$1,059,690CYInvestmentIncomeAmt
PY Other Revenue-$34,171PYOtherRevenueAmt
CY Other Revenue-$34,129CYOtherRevenueAmt
PY Total Revenue$111,677,162PYTotalRevenueAmt
CY Total Revenue$121,477,164CYTotalRevenueAmt
PY Grants And Similar Paid$53,427PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$42,953CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$60,007,853PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$69,848,663CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$165,478CYTotalFundraisingExpenseAmt
PY Other Expenses$49,232,341PYOtherExpensesAmt
CY Other Expenses$48,103,869CYOtherExpensesAmt
PY Total Expenses$109,293,621PYTotalExpensesAmt
CY Total Expenses$117,995,485CYTotalExpensesAmt
PY Revenues Less Expenses$2,383,541PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,481,679CYRevenuesLessExpensesAmt
Total Assets BOY$165,561,926TotalAssetsBOYAmt
Total Assets EOY$174,116,121TotalAssetsEOYAmt
Total Liabilities BOY$79,931,378TotalLiabilitiesBOYAmt
Total Liabilities EOY$80,704,633TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$85,630,548NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$93,411,488NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionEXTRAORDINARY HEALTHCARE FROM THE HEART - ONE PERSON AT A TIME.VISION: WE WILL SET THE STANDARD FOR COMMUNITY-BASED HEALTHCARE THAT IMPROVES THE HEALTH AND QUALITY OF LIFE OF THE PEOPLE WE SERVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$73,041,636ExpenseAmt
Grant$42,953GrantAmt
Revenue$99,786,989RevenueAmt
DescSAUK PRAIRIE HEALTHCARE, INC. (THE "HOSPITAL"), A 36-BED ACUTE CARE GENERAL HOSPITAL, IS A NONPROFIT, NONSTOCK WISCONSIN CORPORATION PROVIDING SERVICES TO SAUK CITY, PRAIRIE DU SAC, AND THE SURROUNDING COMMUNITIES. TOTAL ADMISSIONS FOR 2023 WERE 1,518 (PY: 1,641) WITH PATIENT DAYS OF 3,289 (PY:4,166). KEY PATIENT SERVICES INCLUDING 427 (PY:385) BIRTHS IN THE NURSERY, 5,510 (PY:5,107) SURGICAL PROCEDURES, 70,487 (PY:62,921) REHABILITATION THERAPY SERVICES, 38,111 (PY:36,218) MEDICAL IMAGING SERVICES, AND 20,067 (PY:18,660) EMERGENCY ROOM VISITS ARE AMONG MANY OF THE SERVICES PROVIDED TO PATIENTS DURING 2023. THE HOSPITAL FULFILLS ITS MISSIONS AND VISION BY OFFERING HIGH-QUALITY SERVICES IN RURAL COMMUNITIES, THEREBY ALLOWING OUR PATIENTS TO BE TREATED LOCALLY WITHOUT LENGTHY COMMUTES OR WAITING. THE HOSPITAL HAS GAINED A REGIONAL REPUTATION OF EXCELLENCE IN ORTHOPEDICS, GENERAL SURGERY, AND GYNECOLOGY SURGERY. THE HOSPITAL OPERATES FOUR CLINICS IN RURAL AREAS: LODI, SPRING GREEN, PLAIN, AND MAZOMONIE, BRINGING PRIMARY CARE TO THOSE COMMUNITIES. THE CLINICS HAD CLOSE TO 31,330 (PY:31,023) VISITS IN 2023. AS A CHARITABLE ORGANIZATION, THE HOSPITAL PROVIDED ALMOST $2.7 MILLION (PY:$1.8 MILLION) IN FREE CARE TO PATIENTS IN OUR SERVICE AREA IN 2023, IN ADDITION TO SUBSIDIZING SERVICES THAT DO NOT COVER COSTS, FREE HEALTH SCREENINGS, EDUCATION PROGRAMS, AND YOUTH OUTREACH.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$21,221,580ExpenseAmt
Grant$0GrantAmt
Revenue$20,539,218RevenueAmt
DescTHE HOSPITAL ALSO OWNS AND OPERATES PHYSICIAN PRACTICES IN SPRING GREEN (DBA RIVER VALLEY CLINIC), MAZOMANIE (DBA WISCONSIN HEIGHTS CLINIC), PLAIN, AND LODI, WISCONSIN, AS WELL AS OPERATES ORTHOPEDIC AND SURGICAL PHYSICIAN PRACTICES IN PRAIRIE DE SAC, WISCONSIN. TOTAL CLINIC VISITS TO THESE FIVE SITES FOR 2023 WAS 53,379 (PY:50,308).Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$94,263,216TotalProgramServiceExpensesAmt
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 EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
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 FootnoteYes (1)IncludeFIN48FootnoteInd
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 Organizations0GrantsToOrganizationsInd
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 MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (1)BusinessRlnWith35CtrlEntInd
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 Document41IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee845EmployeeCnt
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 Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
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 BodyYes (1)Form990ProvidedToGvrnBodyInd
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

FieldValueIRS element (for citing)
PersonJAMES DREGNEYPersonNm
Phone6086433311PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1260 26TH STREETAddressLine1Txt
CityPRAIRIE DU SACCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53578ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
RYAN KRAEMER
PRESIDENT5.00Yes (X)Yes (X)$7,500$0$0
TOM SCHWARZ
TRUSTEE2.50Yes (X)$1,667$0$0
KARI APEL
TREASURER3.00Yes (X)Yes (X)$7,218$0$0
TODD SCHAD MD
TRUSTEE2.50Yes (X)$5,000$0$0
NATHAN KEISER
TRUSTEE3.00Yes (X)$2,333$0$0
ANDREA WYTTENBACH GAVOL
TRUSTEE & VICE PRESIDENT2.00Yes (X)Yes (X)$5,000$0$0
TIM HOMAR
TRUSTEE2.00Yes (X)$6,750$0$0
JEFF WRIGHT
SECRETARY3.00Yes (X)Yes (X)$4,593$0$0
BRIAN GORMAN
TRUSTEE2.00Yes (X)$4,000$0$0
BILL DALRYMPLE
TRUSTEE1.00Yes (X)$4,000$0$0
SARA SHACKLETON
TRUSTEE2.00Yes (X)$4,336$0$0
CLINTON MACKINNEY
TRUSTEE2.00Yes (X)$4,000$0$0
SHAWN LERCH
CEO50.00Yes (X)$406,453$0$47,858
JAMES DREGNEY
CFO50.00Yes (X)$314,277$0$50,739
LISA PICKARTS
VP PATIENT SERVICES50.00Yes (X)$172,353$0$25,020
ANDREW ERTL MD
SURGEON40.00$1,648,696$0$53,994Yes (X)
MICHAEL LAMSON MD
SURGEON40.00$1,344,905$0$50,859Yes (X)
DAVID MARCU MD
SURGEON40.00$1,348,170$0$50,267Yes (X)
MATTHEW HEBERT MD
SURGEON40.00$1,278,266$0$55,429Yes (X)
THEODORE PARINS MD
SURGEON40.00$622,685$0$54,083Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$7,192,202TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$388,249TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K100IndivRcvdGreaterThan100KCnt
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
KRAEMER BROTHERS
925 PARK AVEPLAINWI53577GENERAL CONTRACTOR$733,581
CLOUDWAVE
8401 CHAGRIN RD STE 6BCHAGRIN FALLSOH44023HEALTHCARE DATA SECURITY$640,549
BURLINGTON HEALTHCARE PROVIDERS
W329 N4476 LAKELAND DRNASHOTAHWI53508CONTRACTED PHYSICIANS$551,198
CENTRAL MINNESOTA DIAGNOSTICS
150 10TH STREET NWMILACAMN563531221CT & MRI SERVICES$545,246
AGILITI HEALTH
PO BOX 851313MINNEAPOLISMN55485MEDICAL EQUIPMENT SUPPLY SERVICE$541,409
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K29CntrctRcvdGreaterThan100KCnt
Related Organizations$125,396RelatedOrganizationsAmt
Total Contributions$125,396TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
HOSPITAL PATIENT REVENUE621990$98,258,676$98,258,676
CLINIC REVENUE621110$20,539,218$20,539,218
OTHER HOSPITAL SERVICES621990$1,260,533$1,260,533
CAFETERIA AND VENDING621990$267,780$267,780
FieldValueIRS element (for citing)
Total Program Service Revenue$120,326,207TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,326,812TotalRevenueColumnAmt
Exclusion$1,326,812ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$142,117RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$176,246RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$34,129RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$34,129TotalRevenueColumnAmt
Exclusion-$34,129ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$5,442,219SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$5,699,333SecuritiesAmt
Other$10,008OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$257,114SecuritiesAmt
Other-$10,008OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$267,122TotalRevenueColumnAmt
Exclusion-$267,122ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$121,477,164TotalRevenueColumnAmt
Related Or Exempt Func Income$120,326,207RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,025,561ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$42,953TotalAmt
Program Services$42,953ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,048,077TotalAmt
Management And General$1,048,077ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$55,773,671TotalAmt
Program Services$45,960,795ProgramServicesAmt
Management And General$9,695,998ManagementAndGeneralAmt
Fundraising$116,878FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,225,525TotalAmt
Program Services$1,823,067ProgramServicesAmt
Management And General$396,219ManagementAndGeneralAmt
Fundraising$6,239FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,403,236TotalAmt
Program Services$6,041,143ProgramServicesAmt
Management And General$1,341,319ManagementAndGeneralAmt
Fundraising$20,774FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,398,154TotalAmt
Program Services$2,667,222ProgramServicesAmt
Management And General$722,607ManagementAndGeneralAmt
Fundraising$8,325FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$233,197TotalAmt
Management And General$233,197ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$154,837TotalAmt
Management And General$154,837ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$9,905,051TotalAmt
Program Services$8,075,431ProgramServicesAmt
Management And General$1,829,620ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$360,915TotalAmt
Program Services$12,198ProgramServicesAmt
Management And General$348,717ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,979,530TotalAmt
Program Services$1,396,322ProgramServicesAmt
Management And General$583,208ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,796,088TotalAmt
Management And General$1,796,088ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,341,307TotalAmt
Program Services$170,503ProgramServicesAmt
Management And General$1,170,804ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$23,881TotalAmt
Program Services$19,961ProgramServicesAmt
Management And General$3,920ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,346,368TotalAmt
Program Services$2,295,446ProgramServicesAmt
Management And General$50,922ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,460,644TotalAmt
Program Services$4,152,525ProgramServicesAmt
Management And General$308,119ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$422,692TotalAmt
Program Services$79,465ProgramServicesAmt
Management And General$343,227ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
MEDICAL SUPPLIES$15,737,470$15,737,470
REPAIRS & MAINTENANCE$3,405,190$2,262,742$1,142,448
MISCELLANEOUS EXPENSES$2,193,037$1,697,214$482,561$13,262
MEDICAID ASSESSMENT TAX$1,299,234$1,299,234

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,444,428TotalAmt
Program Services$1,828,759ProgramServicesAmt
Management And General$615,669ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$117,995,485TotalAmt
Program Services$94,263,216ProgramServicesAmt
Management And General$23,566,791ManagementAndGeneralAmt
Fundraising$165,478FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$601,269BOYAmt
EOY$675,603EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$19,200,799BOYAmt
EOY$19,212,198EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$18,451,043BOYAmt
EOY$18,746,471EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,446,323BOYAmt
EOY$1,379,218EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,497,518BOYAmt
EOY$1,569,202EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$140,639,072LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$77,129,665LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$61,154,315BOYAmt
EOY$63,509,407EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$45,837,048BOYAmt
EOY$51,356,324EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$965,525BOYAmt
EOY$990,142EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$16,408,086BOYAmt
EOY$16,677,556EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$165,561,926BOYAmt
EOY$174,116,121EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$11,038,741BOYAmt
EOY$11,914,059EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$42,446BOYAmt
EOY$40,944EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$52,606,780BOYAmt
EOY$51,078,248EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,243,411BOYAmt
EOY$17,671,382EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$79,931,378BOYAmt
EOY$80,704,633EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$80,895,032BOYAmt
EOY$88,105,290EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,735,516BOYAmt
EOY$5,306,198EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$85,630,548BOYAmt
EOY$93,411,488EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$165,561,926BOYAmt
EOY$174,116,121EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,481,679ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$3,728,579NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$570,682OtherChangesInNetAssetsAmt
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 MembersYes (1)MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$28,909OtherActivitiesAmt
Total Lobbying Expenditures$28,909TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind
Form4720 Filed4912 Tax0Form4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationPART II-B, LINE 1: SAUK PRAIRIE HEALTHCARE ("THE HOSPITAL) PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING DEVELOPMENT. THE HOSPITAL IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, THE HOSPITAL PAYS MEMBERSHIP FEES TO THE RWHC. THE RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST AND EMERGENCY ROOM PATIENT CARE COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO DOES PROVIDE ANALYSIS ON CURRENT HEALTHCARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTHCARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON THE PART OF THE MEMBER ORGANIZATIONS. PART II-B, LINE 1 (D AND G): REPRESENTATIVES FROM THE HOSPITAL ANNUALLY PARTICIPATE IN THE WISCONSIN HOSPITAL ASSOCIATION'S ADVOCACY DAY WHERE THE REPRESENTATIVES ARE GIVEN THE OPPORTUNITY TO GATHER WITH OTHER HEALTHCARE ORGANIZATIONS IN THE STATE OF WISCONSIN AND ALSO MEET WITH STATE GOVERNMENT REPRESENTATIVES WITH THE PURPOSE OF IMPROVING THE DELIVERY OF HEALTHCARE NOT ONLY AT SAUK PRAIRIE HEALTHCARE BUT ALSO COLLECTIVELY IN THE STATE OF WISCONSIN. AS ISSUES OR PROPOSED LEGISLATION ARISE THROUGHOUT THE YEAR, OFFICIALS OF THE HOSPITAL WILL SEND LETTERS OF COMMENT TO LOCAL, STATE, AND FEDERAL GOVERNMENT REPRESENTATIVES TO EITHER SHOW SUPPORT OF PROPOSED CHANGES OR VOICE AN OPINION TO IMPROVE THE OUTCOME OF PROPOSED LEGISLATION OR OTHER CHANGES. THESE ACTIVITIES RESULT IN MINIMAL COST TO THE OPERATION OF THE HOSPITAL.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,819,075BeginningYearBalanceAmt
Investment Earnings Or Losses$279,573InvestmentEarningsOrLossesAmt
End Year Balance$3,098,648EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,130,485BeginningYearBalanceAmt
Investment Earnings Or Losses-$311,410InvestmentEarningsOrLossesAmt
End Year Balance$2,819,075EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,778,480BeginningYearBalanceAmt
Investment Earnings Or Losses$352,005InvestmentEarningsOrLossesAmt
End Year Balance$3,130,485EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,468,306BeginningYearBalanceAmt
Investment Earnings Or Losses$310,174InvestmentEarningsOrLossesAmt
End Year Balance$2,778,480EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,047,424BeginningYearBalanceAmt
Investment Earnings Or Losses$420,881InvestmentEarningsOrLossesAmt
End Year Balance$2,468,306EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.69000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.31000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,341,773OtherCostOrOtherBasisAmt
Book Value$7,341,773BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$65,049,872OtherCostOrOtherBasisAmt
Depreciation$27,929,570DepreciationAmt
Book Value$37,120,302BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,682,538OtherCostOrOtherBasisAmt
Depreciation$1,001,382DepreciationAmt
Book Value$681,156BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$62,903,892OtherCostOrOtherBasisAmt
Depreciation$48,198,713DepreciationAmt
Book Value$14,705,179BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,660,997OtherCostOrOtherBasisAmt
Book Value$3,660,997BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$63,509,407TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
INVESTMENTS IN AFFILIATES$5,306,196
FINANCE LEASE ASSETS$622,080
OPERATING LEASE ASSETS$10,749,280
FieldValueIRS element (for citing)
Total Book Value Other Assets$16,677,556TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DEFERRED COMPENSATION LIABILITY$4,740,801
THIRD PARTY SETTLEMENTS$1,277,777
LEASE LIABILITIES$11,652,804
FieldValueIRS element (for citing)
Total Liability$17,671,382TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$120,189,950TotalRevEtcAuditedFinclStmtAmt
Other Revenue$176,246OtherRevenueAmt
Revenue Not Reported$176,246RevenueNotReportedAmt
Revenue Subtotal$120,013,704RevenueSubtotalAmt
Other Revenues Not Included$1,463,460OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$1,463,460RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$121,477,164TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$116,708,272TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$176,247OtherExpensesIncludedAmt
Expenses Not Reported$176,247ExpensesNotReportedAmt
Expenses Subtotal$116,532,025ExpensesSubtotalAmt
Other Expenses Not Included$1,463,460OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$1,463,460ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$117,995,485TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE SCHNELLER SISTERS FUND SHALL BE HELD AS A SEPARATE PERMANENT ENDOWMENT FUND ON THE BOOKS AND RECORDS OF THE FOUNDATION, THE INCOME FROM WHICH SHALL BE DISTRIBUTED TO SAUK PRAIRIE HEALTHCARE FOR UNRESTRICTED NEEDS. ALL DISTRIBUTIONS FROM THE SCHNELLER SISTERS FUND SHALL BE DESIGNATED AS HAVING BEEN MADE "IN MEMORY OF THE SCHNELLER SISTERS: CECELIA SCHNELLER MUELLER, ADLYNN F. BALFANZ, AND MARY ANN ROSAR."
PART X, LINE 2:IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE HOSPITAL ASSESSES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF DECEMBER 31, 2023 OR 2022.
PART XI, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSE 176,246.
PART XI, LINE 4B - OTHER ADJUSTMENTS:GOOD NEIGHBOR CLINIC SERVICES PROVIDED 262,188. BAD DEBT EXPENSE 1,201,272.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES 176,247.
PART XII, LINE 4B - OTHER ADJUSTMENTS:GOOD NEIGHBOR CLINIC SERVICES PROVIDED 262,188. BAD DEBT EXPENSE 1,201,272.

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
Percent100Yes (X)Percent100Ind
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$941,537TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$941,537NetCommunityBenefitExpnsAmt
Total Expense0.00800TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,545,599TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,525,096DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,020,503NetCommunityBenefitExpnsAmt
Total Expense0.04250TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,487,136TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,525,096DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,962,040NetCommunityBenefitExpnsAmt
Total Expense0.05050TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$404,929TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$404,929NetCommunityBenefitExpnsAmt
Total Expense0.00340TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$262,907TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$262,907NetCommunityBenefitExpnsAmt
Total Expense0.00220TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$21,063,109TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,505,051DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,558,058NetCommunityBenefitExpnsAmt
Total Expense0.03860TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$173,010TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$173,010NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$21,903,955TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,505,051DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,398,904NetCommunityBenefitExpnsAmt
Total Expense0.04570TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$32,391,091TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,030,147DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,360,944NetCommunityBenefitExpnsAmt
Total Expense0.09620TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,848TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,848NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,764TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,764NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,612TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,612NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$1,201,272BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$21,265,226ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$25,209,263CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$3,944,037MedicareSurplusOrShortfallAmt

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 Line1SAUK PRAIRIE HEALTHCARE INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1260 26TH STREETAddressLine1Txt
CityPRAIRIE DU SACCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53578ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.SAUKPRAIRIEHEALTHCARE.ORGWebsiteAddressTxt
State License122StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SAUK PRAIRIE 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 Conducted21CHNAConductedYr
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 B, LINE 7DOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION B, LINE 7DStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.SAUKPRAIRIEHEALTHCARE.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.SAUKPRAIRIEHEALTHCARE.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.SAUKPRAIRIEHEALTHCARE.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCFAPSummaryOnWebsiteURLTxt
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
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
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 Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 3J: INPUT FROM LOCAL PHYSICIANS WITH REGARD TO THE HIGHEST COMMUNITY HEALTH NEEDS WAS ALSO INCLUDED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT.
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 5: ALONG WITH COLLECTING AND ANALYZING DATA FROM THE SAUK COUNTY HEALTH AND WELLNESS COALITION SURVEY (INCLUDING 648 RESPONDENTS FROM THE SPH SERVICE AREA) AND ONLINE DATA SOURCES, SIX KEY INFORMANT FOCUS GROUP MEETINGS WERE CONDUCTED WITH STAKEHOLDERS REPRESENTING BROAD INTERESTS OF THE AREA. THE GROUPS INCLUDED, BUT WERE NOT LIMITED TO, SCHOOL REPRESENTATIVES, LAW ENFORCEMENT OFFICERS, HEALTHCARE PROVIDERS, EMERGENCY RESPONSE PROFESSIONALS, CLERGY MEMBERS, MUNICIPAL OFFICIALS, AND COMMUNITY GROUP LEADERS. THE QUESTIONS ASKED WERE RELATED TO GENERAL COMMUNITY ISSUES AND CONCERNS, AT RISK POPULATIONS, ISSUES IN THE COMMUNITY THAT PROMOTE POOR HEALTH, AND ISSUES RELATED TO HEALTHCARE ACCESS. AT THE MEETINGS, HEALTH CONCERNS WERE IDENTIFIED AND PRIORITIZED. IN ADDITION TO THE KEY INFORMANT MEETINGS FACILITATED BY SPH, MANY OTHER COMMUNITY FORUMS WERE HELD BY MEMBERS OF THE SAUK COUNTY HEALTH AND WELLNESS COALITION. ON JANUARY 16, 2021, A "CREATING OUR HEALTH COMMUNITY PLAN" FORUM AND PRIORITY SESSION WAS HELD IN SAUK PRAIRIE. AT THIS STRATEGY SESSION (SEE CHNA APPENDIX FOR A LIST OF PARTICIPANTS AND MEETINGS).
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS: ST. CLARE/SSM HOSPITAL (BARABOO, WI) AND REEDSBURG AREA MEDICAL CENTER (REEDSBURG, WI). SAUK PRAIRIE HEALTHCARE, INC. ALSO WORKED WITH THE RICHLAND HOSPITAL (RICHLAND CENTER) AND UPLAND HILLS HEALTH (DODGEVILLE), BUT TO A LESSER DEGREE THAN ST. CLARE AND REEDSBURG.
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 6B: SAUK PRAIRIE HEALTHCARE WORKED WITH SAUK COUNTY DEPARTMENT OF HEALTH TO IDENTIFY AND PRIORITIZE HEALTH NEEDS. THIS GROUP MEETS ON AT LEAST A QUARTERLY BASIS TO CONTINUALLY ASSESS NEEDS AND COORDINATE AND REPORT ON HEALTH INITIATIVE PROGRESS IN EACH MEMBER'S RESPECTIVE SERVICE AREA.
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 7D: THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS MADE PUBLICLY AVAILABLE IN MAY 2022 VIA THE SAUK PRAIRIE HEALTHCARE WEBSITE AT WWW.SAUKPRAIRIEHEALTHCARE.ORG/ABOUT/COMMUNITY-HEALTH/. THE CHNA WAS INTERNALLY ANNOUNCED TO EMPLOYEES AND MEDICAL STAFF OF THE HOSPITAL IN JANUARY 2022. IN ADDITION, THE CHNA HAS BEEN PRESENTED AT THE PRAIRIE DU SAC VILLAGE BOARD ON JULY 26, 2022 AND IS SCHEDULED TO BE PRESENTED AT THE SAUK CITY VILLAGE BOARD DURING ITS AUGUST 30, 2022 MEETING. IN ADDITION, THE CHNA WILL BE PRESENTED TO THE SAUK PRAIRIE SCHOOL DISTRICT ON AUGUST 22, 2022, THE SAUK PRAIRIE SOCIAL JUSTICE AND EQUITY INITIATIVE COMMITTEE ON AUGUST 23, 2022, AND THE SAUK PRAIRIE CHAMBER BOARD ON OCTOBER 20, 2022. A PRESS RELEASE WAS CREATED AND SENT TO THE AREA PAPERS THE WEEK OF AUGUST 1, 2022.
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 11: THE FOLLOWING ACTIONS WERE DONE IN 2023 TO ADDRESS SIGNIFICANT HEALTH NEEDS IDENTIFIED IN SPH'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. (1) SPH CONTINUED TRACKING MONTHLY ADVANCE DIRECTIVES WITH PATIENTS TO ASSIST IDENTIFYING TRENDS AND PATTERNS. (2) SAUK PRAIRIE HEALTHCARE FOUNDATION ("SPHF") IN 2023, SAUK PRAIRIE HEALTHCARE HELD MHFA CLASSES ON 03/08 IN LODI WITH 15 PARTICIPANT AND ON 11/9 IN SPRING GREEN WITH 7 PARTICPANTS. (3) IN CONTINUING OUR EFFORTS TO REDUCE THE PREVALENCE OF TYPE 2 DIABETES, SPH HELD SPRING AND FALL DIABETES PREVENTION AND LIFESTYLE CHANGE PROGRAMS WITH A TOTAL OF 23 PARTICIPANTS. (4) THROUGH EFFORTS TO EDUCATE STUDENTS ON THE HEALTH BENEFITS OF FRUITS AND VEGETABLES, SPH HELD STIR IT UP PROGRAMS AT LODI MIDDLE SCHOOL AND TOWER ROCK ELEMENTARY. (5) TO HELP PREVENT SUICIDE AND SHARE RESOURCES AND EDUCATION TO LOWER THE LIKELIHOOD THAT OUR COMMUNITY WILL LOSE A MEMBER TO SUICIDE, SPH HAS ONE EMPLOYEE ACTIVELY INVOLVED WITH THE FARMER ANGEL NETWORK, WHICH IS A COLLABORATION OF SAUK CO. PUBLIC HEALTH, EXTENSION SAUK CO., PROJECT RECOVERY, LOCAL CHURCHES AND CONCERNED FARMERS. (6) SPH HELD SEVERAL YOUTH FEMALE EMPOWERMENT PROGRAMS THROUGH SMOOTHIE CLASSES HELD AT AREA MIDDLE SCHOOLS IN MAY, JULY AND NOV 2023.(7) SPH FOUNDATION DONATED A COMBINED $30,000 TO COMMUNITY PROJECTS THAT CONTRIBUTE TO THE HEALTH OF THE COMMUNITY AS PART OF THE "HEALTHY LIFE GRANTS" PROGRAM.(8) SPH'S FITNESS CENTER HELD STEPPING ON CLASSES WHICH PROMOTES FALL PREVENTION FOR SENIORS, THERE WERE 10 PARTICIPANTS IN THE PROGRAM.(9) SPH'S BEHAVIOR HEALTH PROGRAM CONTINUED IT'S PARTNERSHIP WITH BEND HEALTH IN 2023 ALLOWING PATIENTS ACCESS TO MENTAL HEALTH SERVICES. IN 2024, SPH WILL PARTNER WITH THE SAUK PRAIRIE SCHOOL DISTRICT TO PROVIDE A DEDICATED MENTAL HEALTH THERAPIST FOR THE DISTRICT STUDENTS; INCREASING THE SPEED TO ACCESS CARE FOR THE PATIENT.(10) TO HELP REDUCE SUBSTANCE ABUSE, SPH HAD ONE EMPLOYEE ACTIVELY INVOLVED WITH THE SAUK COUNTY PARTNERSHIP FOR PREVENTION (WEBSITE: HTTPS://P4PSAUK.ORG/ ) WHICH IS AN ALLIANCE OF COMMUNITY MEMBERS AND LOCAL ORGANIZATIONS THAT ARE DEDICATED TO PREVENTING THE DANGEROUS USE OF ALCOHOL, TOBACCO, AND OTHER DRUGS. THE MISSION OF P4P IS USE COLLABORATION, EDUCATION, AND ACTION, WE EMPOWER OUR COMMUNITY TO PREVENT THE DANGEROUS USE OF ALCOHOL AND OTHER DRUGS, AND TO FOSTER HEALTHY LIFESTYLES FOR PEOPLE OF ALL AGES. PARTICIPANTS IN OUR COMMUNITY CONVERSATIONS AND KEY INFORMANT INTERVIEWS HIGHLIGHTED THE BOTH THE HIGH COST AND LIMITED AVAILABILITY OF HOUSING AND THE LACK OF SOCIAL CONNECTEDNESS. DURING KEY INFORMANT INTERVIEWS CONDUCTED BY SPH AND COALITION PARTNERS, THE RECURRING ISSUE REGARDING THE LACK OF TRANSPORTATION AVAILABLE TO THOSE POPULATIONS IN NEED WAS BROUGHT TO THE SURFACE. SPECIFIC ISSUES CITED INCLUDE DIFFICULTY GETTING TO AND FROM MEDICAL AND DENTAL VISITS, GROCERY SHOPPING, TRAVELING TO AND FROM WORK, AND THE ABILITY TO ATTEND SOCIAL ACTIVITIES. THIS ISSUE WAS NOT IDENTIFIED BY SPH AND THE COALITION AS A COMMUNITY HEALTH PRIORITY. RATHER, IT IS CONSIDERED AN ISSUE THAT AFFECTS EACH OF THE STATED PRIORITY AREAS OF EACH ORGANIZATION. TO THE DEGREE POSSIBLE, TRANSPORTATION WILL BE ADDRESSED AS A KEY COMPONENT OF OUR COMMUNITY HEALTH IMPROVEMENT IMPLEMENTATION PLAN (CHIIP).
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 13B: PATIENTS WHO ARE UNABLE TO COMPLETE AN APPLICATION FORM MAY BE ELIGIBLE FOR COMMUNITY CARE IF OTHER EVIDENCE IS AVAILABLE WHICH MAY INDICATE FINANCIAL HARDSHIP. THIS INFORMATION MAY BE OBTAINED FROM A PATIENT INTERVIEW, CREDIT REPORT, OR OTHER AVAILABLE RECORDS. CONSIDERATION WILL BE GIVEN ON AN INDIVIDUAL BASIS.OTHER PROVISIONS UNDER PRESUMPTIVE ELIGIBILITY:I. DECEASED WITH NO ESTATE - BASED ON THE CONCLUSION THAT THE DESCENDANT HAS NO ASSETS, AND THEREFORE NO ABILITY TO PAY. *II. ACCOUNTS UNCOLLECTIBLE DUE TO DISCHARGE OF DEBTOR BY BANKRUPTCY. *III. IF IT HAS BEEN DETERMINED THAT A PATIENT HAS BEEN APPROVED FOR MEDICAL ASSISTANCE, ALL ACCOUNTS CURRENTLY IN THE A/R WITH SPH WILL BE WRITTEN OFF TO COMMUNITY CARE AFTER PAYMENT IS RECEIVED FROM THE INSURANCE. *IV. ANY ACCOUNT RETURNED BY THE COLLECTION AGENCY THAT HAS BEEN DETERMINED TO BE UNCOLLECTIBLE WILL BE CONSIDERED COMMUNITY CARE. *V. QUALIFIED INDIVIDUALS UNDER ANOTHER ORGANIZATION'S SIMILAR COMMUNITY CARE APPLICATION PROCESS.* NO COMMUNITY CARE APPLICATION NEEDS TO BE COMPLETED IN THESE INSTANCES.
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 16J: INFORMATION ABOUT THE POLICY IS INCLUDED ON BILLING INVOICES, ON ADMISSION INFORMATION, ON THE WEBSITE, AND IS REFERENCED IN COLLECTION EFFORTS. IT IS ALSO MENTIONED IN COMMUNITY TALKS ON HEALTH INSURANCE.
FieldValueIRS element (for citing)
Facility8FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - ORTHOPEDIC ASSOCIATES OF SAUK PRAIRIE
250 26TH STREET SUITE 150PRAIRIE DU SACWI53578ORTHOPEDIC CLINIC
2 - LODI MEDICAL CENTER
160 VALLEY DRIVELODIWI53555PHYSICIAN CLINIC
3 - RIVER VALLEY MEDICAL CENTER
436 SUNRISE DRIVESPRING GREENWI53588RURAL HEALTH CLINIC
4 - WISCONSIN HEIGHTS CLINIC
506 CROCKER STREET SUITE 3MAZOMANIEWI53560PHYSICIAN CLINIC
5 - PLAIN MEDICAL CLINIC
825 MAIN STREETPLAINWI53577RURAL HEALTH CLINIC
6 - SURGICAL ASSOCIATES
250 26TH STREET SUITE 210PRAIRIE DU SACWI53577SURGICAL CLINIC
7 - CAMPUS CLINIC
250 26TH STREET SUITE 110PRAIRIE DU SACWI53578PHYSICIAN CLINIC
8 - UROLOGY CLINIC
250 26TH STREET SUITE 210PRAIRIE DU SACWI53577UROLOGY CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:ELIGIBILITY FOR SAUK PRAIRIE HEALTHCARE'S COMMUNITIY CARE (FINANCIAL ASSISTANCE) PROGRAM IS CONSIDERED FOR INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR GOVERNMENTAL HEALTH PLANS, AND WHO ARE UNABLE TO PAY FOR THEIR CARE. ABILITY TO PAY IS DETERMINED BY COMPARING FAMILY INCOME TO FEDERAL POVERTY LEVELS, BUT IT ALSO CONSIDERS THE FAMILY'S ASSETS. DETERMINATIONS ARE BASED UPON AN INDIVIDUAL'S FINANCIAL NEED AND DO NOT TAKE INTO ACCOUNT GENDER, RACE, SOCIAL STATUS, SEXUAL ORIENTATION, OR RELIGIOUS AFFILIATION. INDIVIDUALS MUST RESIDE OR HAVE A PRIMARY CARE PHYSICIAN IN SAUK PRAIRIE HEALTHCARE'S SERVICE AREA TO BE ELIGIBLE. PATIENTS WHO ARE UNABLE TO COMPLETE A COMMUNITY CARE APPLICATION MAY BE ELIGIBLE FOR ASSISTANCE IF OTHER EVIDENCE IS AVAILABLE THAT MAY INDICATE FINANCIAL HARDSHIP. THIS INFORMATION MAY BE OBTAINED FROM A PATIENT INTERVIEW, CREDIT REPORT, OR OTHER AVAILABLE RECORDS. THIS INCLUDES THE FOLLOWING SITUATIONS: (1) DECEASED WITH NO ESTATE (2) DISCHARGE OF DEBTOR BY BANKRUPTCY (3) PATIENT HAS BEEN APPROVED FOR MEDICAL ASSISTANCE (4) ACCOUNT IS RETURNED BY THE COLLECTION AGENCY AS UNCOLLECTIBLE (5) QUALIFICATION UNDER ANOTHER ORGANIZATION'S SIMILAR FINANCIAL ASSISTANCE APPLICATION PROCESS.
PART I, LINE 7:THE COSTING METHODOLOGY USED ON FORM 990 IS PRIMARILY 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 VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER SUGGESTED COSTING METHODS FOR THE FORM 990. THE COSTING METHOD FOR SUBSIDIZED HEALTH SERVICES IS BASED ON INTERNAL RECORDS ALLOCATIONS WHICH ARE SIMILAR TO A DIRECT COSTING ACCOUNTING SYSTEM FOR THESE SERVICES NOTED AS SUBSIDIZED HEALTH SERVICES.
PART I, LINE 7G:SUBSIDIZED HEALTH SERVICES AT SAUK PRAIRIE HEALTHCARE, INC. INCLUDE THE OPERATION OF SEVERAL HOSPITAL DEPARTMENTS THAT OPERATE AT A LOSS FROM OPERATIONS, BUT ARE CONSIDERED VITAL HOSPITAL AND CLINIC SERVICES SUCH AS AUDIOLOGY & SLEEP, DIABETES MANAGEMENT, SURGICAL ASSOCIATES & UROLOGY, AND SEVERAL OTHER DEPARTMENTS. A LARGE PORTION OF THESE SERVICES ARE ACCESSED BY COMMUNITY MEMBERS THROUGH THE HOSPITAL'S EMERGENCY SERVICES DEPARTMENT. IT IS THE GOAL OF SAUK PRAIRIE HEALTHCARE, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY.
PART II, COMMUNITY BUILDING ACTIVITIES:THE ORGANIZATION'S COMMUNITY BUILDING EFFORTS PROMOTE THE PHYSICAL, MENTAL AND ECONOMIC HEALTH OF THE COMMUNITIES IT SERVES. FROM AN ECONOMIC PERSPECTIVE, SAUK PRAIRIE HEALTHCARE, STAFF CONTRIBUTE HUNDREDS OF HOURS TO ECONOMIC DEVELOPMENT (CHAMBERS OF COMMERCE AND ECONOMIC DEVELOPMENT ENTITIES) ACTIVITIES AND SUPPORT WORKFORCE DEVELOPMENT THROUGH COMMUNITY AND EDUCATIONAL PROGRAMS. THE PHYSICAL AND MENTAL HEALTH OF THE COMMUNITY IS SUPPORTED THROUGH THE DEVELOPMENT OF HEALTH-RELATED COALITIONS, PARTICULARLY THE SAUK PRAIRIE WELLNESS MOVEMENT AND THE SAUK COUNTY HEALTH AND WELLNESS COALITION.
PART III, LINE 2:THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES EXCLUDING THE PROVISION FOR BAD DEBT, DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE YEAR TO ESTIMATE THE COST OF CARE FOR INDIVIDUALS WHO HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE HOSPITAL ALSO RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE EXCLUDED FROM GROSS PATIENT SERVICE REVENUE ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL.
PART III, LINE 3:MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE ORGANIZATION HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVEABLE.
PART III, LINE 4:FOR AN EXPLANATION OF THE ORGANIZATION'S BAD DEBT EXPENSE, SEE THE "ACCOUNTS RECEIVABLES AND ALLOWANCE FOR CREDIT LOSSES" PARAGRAPHS IN NOTE 1 OF THE AUDITED FINANCIAL STATEMENTS, LOCATED ON PAGE 8 OF THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8:WHETHER THERE IS SHORTFALL OR A SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PATIENTS, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, 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. THE TOTAL MEDICARE REVENUE SHOWN ON SCHEDULE H IS BASED ON THE IRS FORM 990 INSTRUCTIONS AND ONLY INCLUDE THE CHARGES FROM MEDICARE PROGRAM BENEFICIARIES THAT ARE REPORTED ON THE HOSPITAL'S MEDICARE COST REPORT. THE AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT SAUK PRAIRIE HEALTHCARE, INC., PHYSICIAN SERVICES FOR THE INTERNAL MEDICINE (HOSPITALIST) PROGRAM, PHYSICIAN SERVICES PROVIDED TO TWO OF THE FOUR OUTLYING PHYSICIAN CLINICS, CRNA SERVICES PROVIDED TO PATIENTS UNDERGOING ANESTHESIA AT THE HOSPITAL, AND A SIGNIFICANT PORTION OF LAB AND PHYSICAL THERAPY SERVICES WHICH ARE REIMBURSED BY THE MEDICARE PROGRAM UNDER ANOTHER METHODOLOGY. PHYSICIAN COVERAGE OUTPATIENT LAB SERVICES AND OUTPATIENT PHYSICAL THERAPY SERVICES ARE REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COST OF CARING FOR PATIENTS. EMERGENCY PHYSICIAN 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 SAUK PRAIRIE HEALTHCARE, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHODOLOGY 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 OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE DIVIDED BY HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENT ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES, WHICH ARE REIMBURSED ON A COST REPORTING METHODOLOGY. INCLUDING THE FEE SCHEDULE ITEMS, SUCH AS PHYSICIAN SERVICES, WOULD PRODUCE A LARGER LOSS OR SHORTFALL ON THESE SERVICES TO BE REPORTED ON THE FORM 990 IN ANY GIVEN YEAR.
PART III, LINE 9B:IT IS THE POLICY OF SAUK PRAIRIE HEALTHCARE, INC. THAT EACH PATIENT RECEIVES CARE REGARDLESS OF THE ABILITY TO PAY. IF DURING THE COLLECTION PROCESS A PATIENT DOES NOT COMPLETE THE NECESSARY PAPERWORK OR RESPOND TO ATTEMPTS BY THE HOSPITAL TO PROVIDE CHARITY SERVICES, THE PATIENT MAY STILL REQUEST CHARITY INFORMATION AND COMPLETE THE INFORMATION AT ANY TIME DURING THE COLLECTION PROCESS. THE PATIENT WILL BE REFERRED TO THE HOSPITAL'S CHARITY CARE POLICY AND CAN QUALIFY FOR CHARITY CARE, AND HAVE ANY COLLECTION ISSUES REVERSED BY THE ORGANIZATION, IF THEY SHOW A NEED FOR CARE BASED ON THE HOSPITAL'S POLICY.
PART VI, LINE 2:THE HOSPITAL ENGAGES IN THE FOLLOWING ACTIVITIES TO ASSESS THE HEALTHCARE NEEDS OF THE 42,000 RESIDENT THROUGHOUT ITS 700 SQUARE MILE PRIMARY SERVICE AREA: ANALYZE HEALTH STATUS INFORMATION, EPIDEMIOLOGICAL DATA, AND HOSPITAL DISCHARGE DATA FURNISHED BY THE STATE OF WISCONSIN AND SAUK COUNTY TO IDENTIFY ISSUES AND TRENDS; MEET PERIODICALLY WITH THE COUNTY HEALTH DEPARTMENT AND TWO OTHER NEARBY HOSPITALS TO ASSESS HIGH PRIORITY HEALTH NEEDS AND COORDINATE ACTION; PARTICIPATE IN AND HELP COORDINATE COUNTY-WIDE INPUT SESSIONS WITH THE COUNTY HEALTH DEPARTMENT; LEAD AND PARTICIPATE IN COMMUNITY WELLNESS GROUPS AND INITIATIVES THROUGHOUT THE SERVICE AREA; CONDUCT "COMMUNITY HEALTH NEED" FOCUS GROUPS CONSISTING OF COMMUNITY LEADERS AND RANDOMLY SELECTED RESIDENTS; ANALYZE THE POPULATION-BASED NEED FOR MEDICAL PROVIDERS BY SPECIALTY. THIS INFORMATION IS ASSESSED AND MODIFIED BY MEMBERS OF THE HOSPITAL MEDICAL STAFF; LEADER PARTICIPATION AND LEADERSHIP IN CIVIC AND COMMUNITY SERVICE ORGANIZATIONS; ACTIVELY ENGAGE HOSPITAL BOARD MEMBERS IN COMMUNITY HEALTH IMPROVEMENT INITIATIVES AND PROVIDE THE BOARD WITH MONTHLY UPDATES REGARDING COMMUNITY HEALTH ACTIVITIES.
PART VI, LINE 3:1. AT THE TIME OF REGISTRATION, A REGISTRATION SPECIALIST WILL INQUIRE IF THERE IS HEALTH INSURANCE. IF NOT, THEY WILL BE ADVISED OF THE HOSPITAL'S COMMUNITY CARE PROGRAM IF THEY RESIDE WITHIN OUR SERVICE AREA. THOSE WHO HAVE A SAUK PRAIRIE BASED PHYSICIAN WILL ALSO BE CONSIDERED FOR ELIGIBILITY. COMMUNITY CARE INFORMATION IS ALSO POSTED ON THE HOSPITAL WEBSITE AND BILLS STATE THAT IF THE PATIENT IS HAVING DIFFICULTY PAYING THEY SHOULD CONTACT A HOSPITAL REPRESENTATIVE, AS THEY MAY BE ELIGIBLE FOR FREE OR REDUCED FEES. 2. ANY PATIENT REQUESTING ADDITIONAL INFORMATION ABOUT THE COMMUNITY CARE PROGRAM WILL BE REFERRED TO THE PATIENT ACCOUNTS SPECIALIST, WHO WILL EXPLAIN THE PROGRAM AND ITS ELIGIBILITY CRITERIA. WHEN APPLICABLE, ALL GOVERNMENT ASSISTANCE PROGRAMS SUCH AS MEDICAID, BADGER CARE, AND CRIME VICTIMS MUST BE EXHAUSTED BEFORE APPLYING FOR COMMUNITY CARE (EXCEPTION: THE GOVERNMENT ASSISTANCE PROGRAM APPLICATION MAY BE WAIVED BASED ON RELIGIOUS BELIEFS). COMMUNITY CARE IS NOT AVAILABLE FOR ELECTIVE PROCEDURES. PERSONS RESIDED IN THE SAUK PRAIRIE HEALTHCARE, INC.'S PRIMARY SERVICE AREA WILL BE CONSIDERED FOR ELIGIBILITY DETERMINATION. IN THE CASE OF EMERGENCY SERVICES, COMMUNITY CARE MAY BE EXTENDED TO THOSE RESIDING OUTSIDE OF THE PRIMARY SERVICE AREA. 3. THE INFORMATION IS ALSO POSTED ON OUR WEBSITE UNDER "PREPARING FOR YOUR STAY." IF AT ANY TIME PRIOR TO, DURING, OR AFTER THE SERVICES ARE PROVIDED THE PATIENT EXPRESSED CONCERNS ABOUT PAYMENT, THE COMMUNITY CARE PROGRAM IS EXPLAINED. INFORMATION IS ALSO PRINTED ON PATIENT STATEMENTS AND DISCUSSED WITH THE PATIENT DURING THE BILLING PROCESS.
PART VI, LINE 4:THE HOSPITAL'S PRIMARY SERVICE AREA ENCOMPASSES A 700 SQUARE MILE REGION IN RURAL SOUTH CENTRAL WISCONSIN, INCLUDING SAUK, SOUTHERN COLUMBIA, NORTHWEST DANE, NORTHERN IOWA AND EASTERN RICHLAND COUNTIES. THE HOSPITAL IS LOCATED IN SAUK PRAIRIE (COMMON NAME FOR THE NEIGHBORING MUNICIPALITIES OF SAUK CITY AND PRAIRIE DU SAC) AND THE CLINICS ARE LOCATED IN FOUR TOWNS SURROUNDING SAUK PRAIRIE (MAZOMANIE, SPRING GREEN, PLAIN, AND LODI). NO OTHER HOSPITALS ARE LOCATED WITHIN THE PRIMARY SERVICE AREA, HOWEVER EIGHT INPATIENT HOSPITALS (INCLUDING 5 RURAL AND 3 TERTIARY FACILITIES) ARE LOCATED WITHIN A 30 MILES RADIUS OF SAUK PRAIRIE HEALTHCARE, INC. DEMOGRAPHIC ANALYSIS INDICATES A 5-YEAR GROWTH RATE OF 2.5% COMPARED TO THE STATE OF WISCONSIN'S RATE OF 1.9%. AGE GROUPS THAT WILL GROW AT A CONSIDERABLY FASTER RATE THAN THE STATE INCLUDE 0-17 YEAR OLDS (1.9%), 25-34 (15.2%), AND 65+ (16.65%). HEALTH ISSUES AFFECTING THESE AGE SEGMENTS INCLUDE PRENATAL SCREENING, TEEN PREGNANCY, LACK OF ACCESS TO HEALTHCARE, AND MEDICAL ISSUES ASSOCIATED WITH AGING. THE AREA HAS LITTLE RACIAL AND ETHNIC DIVERSITY, ALTHOUGH THE NUMBER OF HISPANIC RESIDENTS HAS INCREASED CONSIDERABLY SINCE 2000. SPECIFIC HEALTH-RELATED ISSUES CONFRONTING THIS POPULATION INCLUDE DIABETES, ACCESS TO CARE, AND LANGUAGE BARRIERS. AVERAGE HOUSEHOLD INCOME OF SERVICE AREA RESIDENTS IS 10% HIGHER THAN THE STATE AVERAGE. THIS DIFFERENCE IS DUE IN LARGE PART BECAUSE OF THE RELATIVELY STRONG JOB MARKET IN MADISON, WHICH ATTRACTS COMMUTERS FROM THE SERVICE AREA. THROUGHOUT THE SERVICE AREA, HOWEVER, AGRICULTURE AND TOURISM REPRESENT A CONSIDERABLE NUMBER OF LOW-PAYING JOBS, TYPICALLY WITHOUT HEALTH BENEFITS. A PORTION OF THE HOSPITAL PRIMARY SERVICE AREA IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA/POPULATION. THIS AREA IS LOCATED IN THE TOWN OF ARENA (MCD 02575). SAUK COUNTY IS ALSO DESIGNATED AS A HEALTH MANPOWER SHORTAGE AREA FOR PSYCHIATRY.
PART VI, LINE 5:SAUK PRAIRIE HEALTHCARE, INC. IS AN INDEPENDENT COMMUNITY HOSPITAL GOVERNED BY AN 11-MEMBER BOARD OF DIRECTORS WHO RESIDE WITHIN THE PRIMARY SERVICE AREA. THE BOARD IS ELECTED BY THE 120 MEMBER COMMUNITY HOSPITAL ASSOCIATION. AN INDEPENDENT HOSPITAL IS A CRUCIAL PART OF THE HOSPITAL'S VISION, BECAUSE IT KEEPS CONTROL AT THE LOCAL LEVEL, NOT IN A CORPORATE HEADQUARTERS LOCATED ELSEWHERE. LOCAL CONTROL ALLOWS THE HOSPITAL TO MAKE DECISIONS THAT ARE BEST FOR THE LOCAL COMMUNITIES. THE SAUK PRAIRIE HEALTHCARE, INC. MEDICAL STAFF PRIVILEGES QUALIFIED PHYSICIANS IN ITS COMMUNITIES. THE VAST MAJORITY OF THE ACTIVE MEDICAL STAFF PRACTICE SOLELY AT THE SAUK PRAIRIE HEALTHCARE, INC. OR ASSOCIATED CLINICS. THE ORGANIZATIONAL STRATEGIC PLAN SPECIFICALLY ADDRESSES OUR DESIRE TO "IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE AND THE ORGANIZATION'S EFFORTS TO ASSESS THE NEEDS OF THE COMMUNITY AND ADDRESS THOSE NEEDS. SAUK PRAIRIE HEALTHCARE, INC. PROMOTES COMMUNITY HEALTH THROUGH A BROAD ARRAY OF APPROACHES. THE FOLLOWING LIST DESCRIBES SPECIFIC PROGRAMS AND ACTIVITIES THAT CONTRIBUTE TO IMPROVING THE HEALTH OF THE COMMUNITY AND ENHANCING THE PROVISION OF MEDICAL CARE: TRAINING MEDICAL STUDENTS, NURSING STUDENTS, AND OTHER HEALTH PROFESSIONS; CONTRIBUTE TIME AND FINANCIAL RESOURCES IN THE DEVELOPMENT OF A DENTAL CLINIC, COLLABORATIVE WITH OTHER INDIVIDUALS AND ORGANIZATIONS IN THE COMMUNITY, TO PROVIDE DENTAL SERVICES TO UNINSURED AND UNDERINSURED MEMBERS OF THE COMMUNITIES SERVED WHO WOULD OTHERWISE NOT HAVE ACCESS OR THE ABILITY TO ACCESS THESE SERVICES ON A REGULAR BASIS; ORGANIZE AND/OR PARTICIPATE IN HEALTH FAIRS; OFFER CPR/FIRST AID CLASSES; ISSUE EDUCATIONAL NEWS RELEASES; CONDUCT COMMUNITY-BASED CLINICAL SCREENINGS (HEARING AID CHECKS, BLOOD PRESSURE, AND CHOLESTEROL SCREENING); PROVIDE SERVICES FOR THE GOOD NEIGHBOR CLINIC OF SAUK PRAIRIE, INC. (LOCAL FREE CLINIC); MEDICATION TAKE BACK DAY; DISCOUNTED EQUIPMENT AND SUPPLIES; ADVANCED DIRECTIVES COUNSELING; BLOOD DRIVES; BREASTFEEDING EDUCATION; CANCER EDUCATION; CLINICS FOR UNDERINSURED/LAB & MEDICATION COSTS; COMMUNITY GARDEN; COMMUNITY HEALTH IMPROVEMENT ADVOCACY; DIABETES EDUCATION; FAMILY/PARENTING/SIBLING EDUCATION; IMMUNIZATIONS/PERTUSSIS; MOBILE MEALS; PRESCRIPTION DRUG COLLECTION; SCHOOL-BASED HEALTH EDUCATION PROGRAMS; SCREENING/HEARING; SELF-HELP/CARDIAC REHAB; SELF-HELP/FITNESS AND EXERCISE; SELF-HELP/NUTRITION AND WEIGHT MANAGEMENT; SELF-HELP/SPORTS INJURY PREVENTION; SHARPS COLLECTION; SUPPORT GROUPS-BEREAVEMENT/GRIEF; SUPPORT GROUPS-BREASTFEEDING; SUPPORT GROUP-DIABETES; SUPPORT GROUPS-NEW MOM; SUPPORT GROUPS-SLEEP APNEA; TRANSPORTATION TOKENS (BUS, CAB FARE).
PART VI, LINE 7, REPORTS FILED WITH STATESWI

Schedule I IRS990ScheduleI

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Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeTUITION REIMBURSEMENTGrantTypeTxt
Recipient16RecipientCnt
Cash Grant$42,953CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTO SUPPORT THE NEEDS OF LOW-INCOME COMMUNITY MEMBERS, SAUK PRAIRIE HEALTHCARE (SPH) PROVIDES SPACE IN OUR OLD HOSPITAL TO GOOD NEIGHBOR CLINIC TO SERVE THOSE INDIVIDUALS. ANY PRODUCTS GIVEN TO GOOD NEIGHBOR CLINIC ARE HAND-DELIVERED. THE SHARED SPACE ENABLES SPH TO SEE HOW THE SUPPLIES ARE BEING USED. SPH ALSO PROVIDES FINANCIAL ASSISTANCE TO EMPLOYEES OF SPH TO ADVANCE THEIR KNOWLEDGE, SKILLS AND ABILITIES THROUGH POST-SECONDARY EDUCATION. APPLICATION FOR TUITION REIMBURSEMENT MUST BE MADE AT LEAST TWO WEEKS PRIOR TO THE COURSE STARTING DATE. THE APPLICATION MATERIALS MUST INCLUDE A COPY OF THE CLASS OR CURRICULUM DESCRIPTION BEING SUBMITTED FOR APPROVAL AND THE COST PER COURSE OR PER CREDIT. THE TUITION REIMBURSEMENT REQUEST FORM MUST BE COMPLETED AND SIGNED BY THE EMPLOYEE, DEPARTMENT DIRECTOR, AND VICE PRESIDENT PRIOR TO THE FIRST DATE OF CLASS. WITHIN 60 DAYS OF COMPLETION OF THE COURSE(S), THE EMPLOYEE MUST SUBMIT RECEIPTS FOR TUITION PAID BY THE EMPLOYEE AND PROOF OF SATISFACTORY COMPLETION TO THE HUMAN RESOURCES DEPARTMENT. UPON VERIFICATION OF ALL INFORMATION, HUMAN RESOURCES WILL ARRANGE FOR A REIMBURSEMENT CHECK TO BE ISSUED TO THE EMPLOYEE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
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 (8 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 ERTL MD
SURGEON$531,763$0$958,625$0$158,308$0$16,500$0$37,494$0$1,702,690$0$0$0
DAVID MARCU MD
SURGEON$502,893$0$702,857$0$142,420$0$16,500$0$33,767$0$1,398,437$0$0$0
MICHAEL LAMSON MD
SURGEON$509,817$0$736,580$0$98,508$0$16,500$0$34,359$0$1,395,764$0$0$0
MATTHEW HEBERT MD
SURGEON$514,672$0$640,819$0$122,775$0$16,500$0$38,929$0$1,333,695$0$0$0
THEODORE PARINS MD
SURGEON$285,785$0$217,267$0$119,633$0$16,500$0$37,583$0$676,768$0$0$0
SHAWN LERCH
CEO$333,590$0$28,350$0$44,513$0$13,847$0$34,011$0$454,311$0$0$0
JAMES DREGNEY
CFO$269,675$0$20,400$0$24,202$0$15,188$0$35,551$0$365,016$0$0$0
LISA PICKARTS
VP PATIENT SERVICES$139,224$0$15,991$0$17,138$0$0$0$25,020$0$197,373$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
A39133785597710B6V92013-01-19$38,000,000CONSTRUCTION OF NEW HOSPITAL000
WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
B3913378552022-02-28$16,657,945REFUND SERIES 2013B BONDS000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndRetiredRetiredAmtOther Spent ProceedsOtherSpentProceedsAmt
A$38,000,000$3,384,222$562,253$34,053,525201400Yes (1)Yes (1)
B$16,657,945$2,000,798$315,4172022Yes (1)0Yes (1)Yes (1)$2,867,682$16,657,945

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00000.000000.000000.0000000Yes (1)
B00000.000000.000000.0000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000Yes (1)0000Yes (1)
B00Yes (1)Yes (1)0000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)

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: 02/26/2018ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KRAEMER BROTHERSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionKRAEMER BROTHERS IS OWNED BY RYAN KRAEMER, THE BOARD PRESIDENTRelationshipDescriptionTxt
Transaction$733,581TransactionAmt
TransactionGENERAL CONTRACTOR SERVICESTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1ATHE BOARD HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE BOARD'S OFFICERS AND THE IMMEDIATE PAST-PRESIDENT OF THE BOARD SO LONG AS THE IMMEDIATE PAST-PRESIDENT IS A MEMBER OF THE BOARD. WHEN A MEETING OF THE WHOLE IS NOT PRACTICAL OR FEASIBLE DUE TO AN EMERGENCY OR URGENCY OF A MATTER, THE EXECUTIVE COMMITTEE MAY EXERCISE ALL POWERS OF THE BOARD WITH RESPECT TO THE MANAGEMENT OF THE ORGANIZATION'S AFFAIRS WHEN THE BOARD IS NOT MEETING, EXCEPT FOR ELECTING OFFICERS OR FILLING VACANCIES ON THE BOARD OR ANY COMMITTEE OF THE BOARD.
FORM 990, PART VI, SECTION A, LINE 6MEMBERSHIP IN SAUK PRAIRIE HEALTHCARE IS OPEN TO ALL PERSONS RESIDING IN THE ORGANIZATION'S SERVICE AREA AND TO THE ORGANIZATION'S CURRENT EMPLOYEES AND MEDICAL STAFF REGARDLESS OF PLACE OF RESIDENCE. THE ORGANIZATION'S SERVICE AREA IS FROM TIME TO TIME DETERMINED BY THE BOARD. MEMBERSHIP IS OPEN TO NATURAL PERSONS ONLY. CORPORATIONS, PARTNERSHIPS, LIMITED LIABILITIY COMPANIES, TRUSTS AND OTHER ENTITIES THAT ARE NOT NATURAL PERSONS ARE NOT ELIGIBLE FOR MEMBERSHIP. ANY NATURAL PERSON WHO PAYS DUES AS PROVIDED HEREIN SHALL BE A MEMBER OF THE ORGANIZATION AND SHALL BE ENTITLED TO VOTE AT THE ANNUAL OR ANY SPECIAL MEETING OF THE MEMBERSHIP. A NATURAL PERSON WHO CONTRIBUTES BY VOLUNTARY DONATION AN AGGREGATE OF $100.00 TO THE ORGANIZATION, WHICH SHALL CONSTITUTE THE DUES ENTITLING SUCH PERSON TO MEMBERSHIP, AND IS EITHER A RESIDENT OF THE SERVICE AREA, A CURRENT EMPLOYEE, OR MEMBER OF THE MEDICAL STAFF, SHALL BE A MEMBER AND SUCH MEMBERSHIP SHALL NOT TERMINATE AS THE RESULT OF SUBSEQUENT RESIDENCE OUTSIDE OF THE SERVICE AREA. MONETARY CONTRIBUTIONS TO THE SAUK PRAIRIE HEALTHCARE FOUNDATION, LTD. SHALL BE APPLIED TOWARD DUES FOR MEMBERSHIP.
FORM 990, PART VI, SECTION A, LINE 7ATHE BOARD OF DIRECTORS SHALL BE ELECTED BY THE MEMBERS AT THE ANNUAL MEETING OF THE MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7BAN ANNUAL MEMBERSHIP SHALL BE ENTITLED TO ONE VOTE AT THE ANNUAL MEETING OR AT ANY SPECIAL MEETINGS OF THE MEMBERSHIP. MEMBERS MAY VOTE ON ELECTIONS OF BOARD MEMBERS, CHANGES TO THE BYLAWS, AND OTHER BUSINESS ALLOWED BY LAW.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WAS REVIEWED IN DETAIL BY THE DIRECTOR OF FINANCE, THE CFO, AND A DISCUSSION WAS HELD WITH THE CEO FOR ANY NEW OR UNUSUAL ITEMS. UPON APPROVAL, THE BOARD OF DIRECTORS RECEIVED AN ELECTRONIC COPY OF THE FORM 990 PRIOR TO SUBMISSION WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CSINCE SAUK PRAIRIE HEALTHCARE, INC. IS A PART OF A SMALL COMMUNITY, CONFLICTS ARE GENERALLY KNOWN, IF NOT DISCLOSED THROUGH THE ANNUAL PROCESS CONDUCTED BY HUMAN RESOURCES. THE ANNUAL PROCESS INCLUDES ALL DIRECTOR LEVEL EMPLOYEES AND ABOVE OF THE HOSPITAL. THE BOARD OF DIRECTORS HAS A CONFLICT OF INTEREST POLICY AND MUST ANNUALLY SIGN A DISCLOSURE FORM STATING ANY POTENTIAL CONFLICTS OF INTEREST. THE BOARD PRESIDENT THEN DISCLOSES ANY CONFLICTS OF INTEREST TO THE FULL BOARD OF DIRECTORS. CONFLICT OF INTEREST STATEMENTS COMPLETED BY BOARD MEMBERS ARE REVIEWED BY THE BOARD PRESIDENT AND EMPLOYEE'S CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY STAFF LEADERSHIP AND/OR ADMINISTRATION. THESE INDIVIDUALS ARE CHARGED WITH THE RESPONSIBILITY OF ENSURING THAT BUSINESS IS CONDUCTED IN A MANNER THAT ADHERES TO THE HOSPITAL'S FORMALLY APPROVED CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF DIRECTORS HAS ESTABLISHED POLICY BG-8 TO ESTABLISH ITS COMPENSATION PHILOSOPHY WITH RESPECT TO EXECUTIVE COMPENSATION AND TO DEFINE PRACTICES ASSOCIATED IN ACCORDANCE WITH IRC 4958. HOSPITAL EXECUTIVE SALARY IS SET ANNUALLY USING COMPARABILITY DATA FROM OUTSIDE CONSULTANTS AND THIRD-PARTY SURVEY DATA. THE EXECUTIVE COMMITTEE IS RESPONSIBLE FOR SETTING SALARY FOR THE CEO BASED ON THE CEO'S JOB PERFORMANCE. THE COMMITTEE RELIES UPON COMPARABILITY DATA DEVELOPED BY OUTSIDE CONSULTANTS TO SUPPORT ITS DECISION MAKING PROCESS AND TO ENSURE COMPETITIVE SALARY LEVELS. THE BOARD REVIEWS BG-8 ANNUALLY AT THE GOVERNANCE COMMITTEE. COMPENSATION FOR OTHER KEY EMPLOYEES IS ESTABLISHED BY APPLICATION OF THE HOSPITAL'S COMPENSATION PHILOSOPHY, WHEREIN RATES OF PAY ARE COMPARED TO MARKET RATES OBTAINED THROUGH PARTICIPATION IN WAGE AND BENEFIT SURVEYS. PAY RANGES ARE OBTAINED FROM SURVEYS OF SIMILARLY SITUATED HOSPITALS LOCATED WITHIN THE STATE OF WISCONSIN IN TERMS OF SIZE AND REVENUE CATEGORY. THE HOSPITAL ADOPTED A "MEET THE MARKET" APPROACH TO COMPENSATION FOR POSITIONS AT THESE LEVELS. THIS MEANS THAT SAUK PRAIRIE HEALTHCARE, INC. TARGETS THE MIDPOINT OF THE PAY RANGE ASSOCIATED WITH EACH POSITION. THE CEO APPROVES COMPENSATION FOR ALL OTHER OFFICERS AND KEY EMPLOYEES BASED ON THE CRITERIA ABOVE.
FORM 990, PART VI, SECTION C, LINE 19THE ABBREVIATED FINANCIAL STATEMENTS ARE A PART OF THE HOSPITAL'S ANNUAL REPORT PRESENTED TO THE PUBLIC AT THE ANNUAL MEETING AND POSTED ON THE HOSPITAL'S WEBSITE. THE ABBREVIATED FINANCIAL STATEMENTS ARE ALSO MADE PUBLICLY AVAILABLE THROUGH THE WISCONSIN HOSPITAL ASSOCIATION. THE HOSPITAL'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 570,682.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
SAUK PRAIRIE HEALTHCARE FOUNDATION LTD
260 26TH STREETPRAIRIE DU SACWI53578930841113FUNDRAISINGWI501(C)(3)LINE 10N/A0
FRIENDS OF SAUK PRAIRIE HEALTHCARE
260 26TH STREETPRAIRIE DU SACWI53578391453754VOLUNTEERINGWI501(C)(3)LINE 12C, III-FIN/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
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 OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd