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CUMBERLAND MEMORIAL HOSPITAL INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
CUMBERLAND MEMORIAL HOSPITAL INC (EIN 39-0831153)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-04-11
IRS object ID
202331019349301603
Schema version
2021v4.2
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)
Return2023-04-11T16:04:44-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

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 Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390831153EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CUMBERLAND MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCUMBBusinessNameControlTxt
Phone7158227500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11110 7TH AVENUEAddressLine1Txt
CityCUMBERLANDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54829ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL GUTSCHPersonNm
Person TitleCEOPersonTitleTxt
Phone7158227500PhoneNum
Signature2023-04-02SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMICHAELPersonFirstNm
Person LastGUTSCHPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHAEL J PETERSON CPAPreparerPersonNm
PTINP01833529PTIN
Phone2187224705PhoneNum
Preparation2023-04-02PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1CUMBERLAND HEALTHCAREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerMICHAEL GUTSCHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11110 7TH AVENUEAddressLine1Txt
CityCUMBERLANDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54829ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$35,413,659GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CUMBERLANDHEALTHCARE.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1955FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionPROVIDE EXCEPTIONAL QUALITY CARE, EVERY STEP OF THE WAY.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee256TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$30,299TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,738,477PYContributionsGrantsAmt
CY Contributions Grants$3,380,917CYContributionsGrantsAmt
PY Program Service Revenue$26,933,654PYProgramServiceRevenueAmt
CY Program Service Revenue$30,986,603CYProgramServiceRevenueAmt
PY Investment Income$819,198PYInvestmentIncomeAmt
CY Investment Income$1,018,842CYInvestmentIncomeAmt
PY Other Revenue$3,956PYOtherRevenueAmt
CY Other Revenue$4,089CYOtherRevenueAmt
PY Total Revenue$31,495,285PYTotalRevenueAmt
CY Total Revenue$35,390,451CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$4,636CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$15,262,474PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$16,395,374CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$11,393,055PYOtherExpensesAmt
CY Other Expenses$15,078,173CYOtherExpensesAmt
PY Total Expenses$26,655,529PYTotalExpensesAmt
CY Total Expenses$31,478,183CYTotalExpensesAmt
PY Revenues Less Expenses$4,839,756PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,912,268CYRevenuesLessExpensesAmt
Total Assets BOY$34,131,044TotalAssetsBOYAmt
Total Assets EOY$48,084,790TotalAssetsEOYAmt
Total Liabilities BOY$12,499,628TotalLiabilitiesBOYAmt
Total Liabilities EOY$24,834,203TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$21,631,416NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$23,250,587NetAssetsOrFundBalancesEOYAmt
MissionTO BE AN INDEPENDENT, COMMUNITY-BASED HEALTH SYSTEM DEDICATED TO PROVIDING EXCEPTIONAL QUALITY CARE, EVERY STEP OF THE WAY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$26,078,649ExpenseAmt
Grant$4,636GrantAmt
Revenue$30,956,304RevenueAmt
DescCUMBERLAND MEMORIAL HOSPITAL, INC. D/B/A CUMBERLAND HEALTHCARE (THE ORGANIZATION") IS AN INDEPENDENT, NONPROFIT, FACILITY THAT SERVES NORTHWEST WISCONSIN. THE ORGANIZATION OPERATES A HOSPITAL (CUMBERLAND MEMORIAL HOSPITAL) AND TWO RURAL HEALTH CLINICS (LOCATED IN CUMBERLAND AND TURTLE LAKE). CUMBERLAND MEMORIAL HOSPITAL BECAME A CRITICAL ACCESS HOSPITAL ON AUGUST 19, 2005, LICENSED FOR 25 ACUTE CARE BEDS. SERVICES INCLUDE, BUT ARE NOT LIMITED TO, THERAPY, WOUND CARE, CHEMOTHERAPY, RADIOLOGY, LAB, AMBULANCE SERVICE AND GENERAL SURGERY. DURING FISCAL YEAR 2022, ACUTE CARE DAYS TOTALED 1220, SWING BED DAYS TOTALED 578.THE ORGANIZATION PROVIDED 18 INPATIENT AND 226 OUTPATIENT SURGERIES ALONG WITH 289 SCOPE PROCEDURES. THERE WERE ALSO 3061 EMERGENCY ROOM VISITS. CUMBERLAND CLINIC TOTAL VISITS WERE 19,226 AND TURTLE LAKE WERE 2,126.Desc
Total Program Service Expenses$26,078,649TotalProgramServiceExpensesAmt
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 ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
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 Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document17IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee256EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
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 Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
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

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANGIE MARTENSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7158227500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11110 7TH AVENUEAddressLine1Txt
CityCUMBERLANDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54829ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
MATT GORES
CHAIRPERSON1.00Yes (X)Yes (X)$3,125$0$0
CANDACE COTONE
VICE CHAIR1.00Yes (X)Yes (X)$2,000$0$0
MARTIN PETERS
TREASURER1.00Yes (X)Yes (X)$2,000$0$0
ANN HENDRICKS
SECRETARY1.00Yes (X)Yes (X)$600$0$0
JOSEPH LESCHISIN
TRUSTEE1.00Yes (X)$2,000$0$0
THOMAS LINGEN MD
TRUSTEE1.00Yes (X)$2,200$0$0
JENNIFER TURCOTT
TRUSTEE1.00Yes (X)$0$0$0
MICHAEL GUTSCH
CEO40.00Yes (X)$273,739$0$33,191
ANGIE MARTENS
CFO40.00Yes (X)$173,653$0$8,969
ROBERT LINDBERG
COO40.00Yes (X)$169,712$0$29,749
DR AMY BAIR
GENERAL SURGEON40.00$402,793$0$24,131Yes (X)
DR CRAIG JENNINGS
PHYSICIAN40.00$320,343$0$40,189Yes (X)
DR KIMBERLY AUCOIN
PHYSICIAN40.00$273,901$0$6,661Yes (X)
DONALD FULLERTON
CRNA20.00$225,364$0$37,191Yes (X)
STEFANIE RINEHARDT
CRNA20.00$207,464$0$42,184Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,058,894TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$222,265TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K26IndivRcvdGreaterThan100KCnt
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
CUMBERLAND CLINIC
1110 7TH AVENUECUMBERLANDWI54829PHYSICIAN SERVICES$1,847,912
ATHENA HEALTH
311 ARSENAL STREETWATERTOWNMA02472ELECTRONIC HEALTH RECORD SERVICES$653,755
MEDICAL INFORMATION TECHNOLOGY
MEDITECH CIRCLEWESTWOODMA02090ELECTRONIC HEALTH RECORD SERVICES$643,047
SHARED MEDICAL TECHNOLOGY
2020 W NEWTON STRICE LAKEWI54868ULTRASOUND SERVICES$445,597
HEALTHEAST MEDICAL LAB
69 W EXCHANGE STST PAULMN55102LAB SERVICES$354,048
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
Fundraising$17,000FundraisingAmt
Government Grants$3,271,559GovernmentGrantsAmt
All Other Contributions$92,358AllOtherContributionsAmt
Total Contributions$3,380,917TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE621990$30,719,633$30,719,633
NURSING HOME REVENUE623000$210,000$210,000

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$56,970TotalRevenueColumnAmt
Related Or Exempt Func Income$26,671RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$30,299UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$30,986,603TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$141,971TotalRevenueColumnAmt
Exclusion$141,971ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$893,773SecuritiesAmt
Other$1,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$17,902OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$893,773SecuritiesAmt
Other-$16,902OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$876,871TotalRevenueColumnAmt
Exclusion$876,871ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$9,395FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$17,000ContriRptFundraisingEventAmt
Fundraising Direct Expenses$5,306FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,089TotalRevenueColumnAmt
Exclusion$4,089ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$35,390,451TotalRevenueColumnAmt
Related Or Exempt Func Income$30,956,304RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$30,299UnrelatedBusinessRevenueAmt
Exclusion$1,022,931ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$4,636TotalAmt
Program Services$4,636ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$501,725TotalAmt
Management And General$501,725ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$12,456,008TotalAmt
Program Services$11,036,906ProgramServicesAmt
Management And General$1,419,102ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$302,533TotalAmt
Program Services$263,722ProgramServicesAmt
Management And General$38,811ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,242,206TotalAmt
Program Services$1,886,972ProgramServicesAmt
Management And General$355,234ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$892,902TotalAmt
Program Services$742,294ProgramServicesAmt
Management And General$150,608ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$37,477TotalAmt
Management And General$37,477ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$89,100TotalAmt
Management And General$89,100ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,678,935TotalAmt
Program Services$4,348,495ProgramServicesAmt
Management And General$330,440ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$109,746TotalAmt
Management And General$109,746ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,565,557TotalAmt
Program Services$1,411,653ProgramServicesAmt
Management And General$153,904ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,382,460TotalAmt
Management And General$1,382,460ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$310,920TotalAmt
Program Services$310,920ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$64,985TotalAmt
Program Services$60,612ProgramServicesAmt
Management And General$4,373ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$3,921TotalAmt
Program Services$2,977ProgramServicesAmt
Management And General$944ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,257,027TotalAmt
Program Services$1,713,663ProgramServicesAmt
Management And General$543,364ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$139,610TotalAmt
Management And General$139,610ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$2,155,615$2,155,615
PHARMACEUTICALS$1,340,932$1,340,932
REPAIRS & MAINTENACE$331,097$329,796$1,301
EQUIPMENT RENTAL$235,929$235,929

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$374,862TotalAmt
Program Services$233,527ProgramServicesAmt
Management And General$141,335ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$31,478,183TotalAmt
Program Services$26,078,649ProgramServicesAmt
Management And General$5,399,534ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,152,825BOYAmt
EOY$912,777EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,024,358BOYAmt
EOY$1,131,317EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,290,435BOYAmt
EOY$5,924,708EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$408,647BOYAmt
EOY$325,000EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$732,136BOYAmt
EOY$785,376EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$73,058BOYAmt
EOY$47,088EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$49,309,615LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$19,518,931LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$10,517,427BOYAmt
EOY$29,790,684EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$10,299,574BOYAmt
EOY$9,037,357EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,632,584BOYAmt
EOY$130,483EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$34,131,044BOYAmt
EOY$48,084,790EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,971,987BOYAmt
EOY$5,442,796EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$824,082BOYAmt
EOY$471,380EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$5,002,477BOYAmt
EOY$18,834,669EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,701,082BOYAmt
EOY$85,358EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,499,628BOYAmt
EOY$24,834,203EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$21,631,416BOYAmt
EOY$23,250,587EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$21,631,416BOYAmt
EOY$23,250,587EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$34,131,044BOYAmt
EOY$48,084,790EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$3,912,268ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$2,293,097NetUnrlzdGainsLossesInvstAmt
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$4,729OtherActivitiesAmt
Total Lobbying Expenditures$4,729TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationCUMBERLAND MEMORIAL HOSPITAL (THE ORGANIZATION") PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTH CARE ENVIRONMENT. THE ORGANIZATION IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, THE ORGANIZATION PAYS MEMBERSHIP FEES TO THE RWHC. 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 HEALTH CARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTH CARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON THE PART OF THE MEMBER ORGANIZATIONS. A PORTION OF THE FEES PAID BY THE ORGANIZATION IN FY 2022 WERE RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTH CARE ENVIRONMENT IN THE STATE OF WISCONSIN.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$939,678OtherCostOrOtherBasisAmt
Book Value$939,678BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,693,005OtherCostOrOtherBasisAmt
Depreciation$12,150,217DepreciationAmt
Book Value$1,542,788BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,743,895OtherCostOrOtherBasisAmt
Depreciation$108,445DepreciationAmt
Book Value$1,635,450BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,007,750OtherCostOrOtherBasisAmt
Depreciation$7,260,269DepreciationAmt
Book Value$1,747,481BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$23,925,287OtherCostOrOtherBasisAmt
Book Value$23,925,287BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$29,790,684TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDEFERRED COMPENSATION PLAN LIABILITIESDesc
Amt$85,358Amt
FieldValueIRS element (for citing)
Total Liability$85,358TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$32,979,774TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$2,293,097NetUnrealizedGainsInvstAmt
Other Revenue-$122,886OtherRevenueAmt
Revenue Not Reported-$2,415,983RevenueNotReportedAmt
Revenue Subtotal$35,395,757RevenueSubtotalAmt
Other Revenues Not Included-$5,306OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$5,306RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$35,390,451TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$31,360,603TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$5,306OtherExpensesIncludedAmt
Expenses Not Reported$5,306ExpensesNotReportedAmt
Expenses Subtotal$31,355,297ExpensesSubtotalAmt
Other Expenses Not Included$122,886OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$122,886ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$31,478,183TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:PROVISION FOR BAD DEBTS NET AGAINST REVENUE -122,886.
PART XI, LINE 4B - OTHER ADJUSTMENTS:FUNDRAISING EXPENSES -5,306.
PART XII, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EXPENSES 5,306.
PART XII, LINE 4B - OTHER ADJUSTMENTS:PROVISION FOR BAD DEBTS NET AGAINST REVENUE 122,886.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF OUTINGEvent1Nm
Gross Receipts Event1$26,395GrossReceiptsEvent1Amt
Charitable Contri Event1$17,000CharitableContriEvent1Amt
Gross Revenue Event1$9,395GrossRevenueEvent1Amt
Cash Prizes Event1$300CashPrizesEvent1Amt
Non Cash Prizes Event1$2,300NonCashPrizesEvent1Amt
Rent Facility Costs Event1$1,580RentFacilityCostsEvent1Amt
Food And Beverage Event1$848FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$278OtherDirectExpensesEvent1Amt
Gross Receipts Total$26,395GrossReceiptsTotalAmt
Charitable Contributions Tot$17,000CharitableContributionsTotAmt
Gross Revenue Total Events$9,395GrossRevenueTotalEventsAmt
Cash Prizes Total Events$300CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$2,300NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$1,580RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$848FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$278OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$5,306DirectExpenseSummaryEventsAmt
Net Income Summary$4,089NetIncomeSummaryAmt

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 Budget0ExpensesExceedBudgetInd
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$59,058TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$59,058NetCommunityBenefitExpnsAmt
Total Expense0.00190TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,568,616TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,448,631DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,119,985NetCommunityBenefitExpnsAmt
Total Expense0.03560TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,627,674TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,448,631DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,179,043NetCommunityBenefitExpnsAmt
Total Expense0.03750TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,853TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,160DirectOffsettingRevenueAmt
Net Community Benefit Expns$25,693NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$58,975TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$58,975NetCommunityBenefitExpnsAmt
Total Expense0.00190TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,430,594TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,195,567DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,235,027NetCommunityBenefitExpnsAmt
Total Expense0.07100TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,636TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,636NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,521,058TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,196,727DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,324,331NetCommunityBenefitExpnsAmt
Total Expense0.07380TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,148,732TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,645,358DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,503,374NetCommunityBenefitExpnsAmt
Total Expense0.11130TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$280TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$280NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$280TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$280NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$64,301BadDebtExpenseAmt
Bad Debt Expense Attributable$12,860BadDebtExpenseAttributableAmt
Reimbursed By Medicare$9,865,601ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$9,767,921CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$97,680MedicareSurplusOrShortfallAmt

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 Line1CUMBERLAND MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11110 7TH AVENUEAddressLine1Txt
CityCUMBERLANDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54829ZIPCd
FieldValueIRS element (for citing)
Website AddressSEE SCHEDULE H PART V SUPPLEMENTALWebsiteAddressTxt
State License1058StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherAMBULANCE SERVICE; RURAL HEALTH CLINICSOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CUMBERLAND MEMORIAL HOSPITALBusinessNameLine1Txt
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
CHNA Conducted18CHNAConductedYr
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
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
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
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
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 URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
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
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
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
CUMBERLAND MEMORIAL HOSPITALPART V, SECTION B, LINE 5: THE 2022 CHNA WAS COMPLETED THROUGH THRIVE BARRON COUNTY, WHICH BRINGS ALL LOCAL COMPETING HEALTHCARE SYSTEMS TOGETHER AND THE BARRON COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES. OVER 800 SURVEYS WERE SENT OUT ELECTRONICALLY AND IN-PERSON TO BARRON COUNTY RESIDENTS ASKING THEM ABOUT WHAT THEY THOUGHT OUR TOP HEALTH CONCERNS WERE. ONCE THE VOTES WERE TALLIED, THE THRIVE BARRON COUNTY STEERING COMMITTEE MET TO DETERMINE THE HEALTH CONCERNS MOVING FORWARD.
CUMBERLAND MEMORIAL HOSPITALPART V, SECTION B, LINE 6A: 2022 CHNA WAS DONE WITH THE FOLLOWING FACILITIES: AMERY REGIONAL MEDICAL CENTER, BARRON COUNTY AGING & DISABILITY RESOURCE CENTER, CUMBERLAND MEMORIAL HOSPITAL, MAYO CLINIC HEALTH SYSTEM AND MARSHFIELD CLINIC HEALTH SYSTEM, BARRON COUNTY PUBLIC HEALTH.
CUMBERLAND MEMORIAL HOSPITALPART V, SECTION B, LINE 6B: CUMBERLAND MEMORIAL HOSPITAL WORKED WITH BARRON COUNTY PUBLIC HEALTH (BARRON, WI) TO IDENTIFY AND PRIORITIZE HEALTH NEEDS.
CUMBERLAND MEMORIAL HOSPITALPART V, SECTION B, LINE 7D: PART V, SECTION B, LINE 7A & 10A:HOSPITAL FACILITIES WEBSITE: CUMBERLANDHEALTHCARE.COM/PATIENTS-VISITORS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/PART V, SECTION B, LINE 7D:SENT TO THRIVE AT BARRON COUNTY AND THEY ALSO DISTRIBUTE AND HAVE THEM AVAILABLE
CUMBERLAND MEMORIAL HOSPITALPART V, SECTION B, LINE 11: BARRON COUNTY HAS CREATED A GROUP CALLED THRIVE BARRON COUNTY, WHICH IS MADE UP OF HEALTHCARE FACILITIES IN THE COUNTY, INCLUDING CUMBERLAND MEMORIAL HOSPITAL. TOGETHER THRIVE BARRON COUNTY CONDUCTED A CHNA AND SINCE THEN EACH YEAR A NEW ASSESSMENT WAS DONE. IN 2022, THE TOP THREE HEALTH CONCERNS WERE ALCOHOL, TOBACCO, AND OTHER DRUG ABUSE (ATODA), MENTAL HEALTH AND CHRONIC DISEASE. GROUPS CALLED CHATS (COMMUNITY HEALTH ACTION TEAMS) WERE FORMED TO ADDRESS THE NEEDS IDENTIFIED AND SINCE 2012 HAVE BEEN WORKING TO BETTER SERVE THE NEEDS OF THE COUNTY RESIDENTS. ADDITIONALLY, CUMBERLAND MEMORIAL HOSPITAL ANNUALLY HOLDS THE "KNOW YOUR NUMBERS" HEALTH FAIR WHICH PROVIDES FREE SCREENINGS TO AREA RESIDENTS THAT COULD POTENTIALLY ADDRESS MAJOR MEDICAL CONCERNS.AS WITH ALL HEALTHCARE ORGANIZATIONS, ADEQUATE RESOURCES ARE NOT AVAILABLE TO ADDRESS EVERY UNMET HEALTH NEED IN THE COMMUNITIES CUMBERLAND MEMORIAL HOSPITAL SERVES. THERE WERE ITEMS IDENTIFIED IN THE CHNA WHICH WERE NOT ADDRESSED; HOWEVER, ALL ITEMS WERE CONSIDERED IF A NEED WAS BROUGHT TO THE ATTENTION OF THE STEERING COMMITTEE DURING THE INFORMATION GATHERING PHASE OF THE CHNA PROCESS. SEVERAL OF THE ITEMS WHICH WERE NOT ADDRESSED PRIMARILY WERE NOT ADDRESSED DUE TO THE FINANCIAL CONSTRAINT OF PROVIDING A NEW SERVICE FOR A LIMITED POPULATION OF PEOPLE. OVER THE NEXT THREE YEARS, CUMBERLAND MEMORIAL HOSPITAL WILL CONTINUE TO PLAY A LEADING ROLE IN ADDRESSING THE HEALTH NEEDS OF THOSE WITHIN THE COMMUNITY, CONGRUENT WITH THE HOSPITAL'S MISSION.
CUMBERLAND MEMORIAL HOSPITALPART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE THROUGH THE BUSINESS OFFICE STAFF. PATIENTS ARE ENCOURAGED TO CONTACT A FINANCIAL COUNSELOR FOR FURTHER INFORMATION ON THE FINANCIAL ASSISTANCE POLICY. THE HOSPITAL'S WEBSITE ALSO ENCOURAGES PATIENTS TO INQUIRE ABOUT THE FINANCIAL ASSISTANCE POLICY.
PART V, LINE 16A, B, C:THE FAP WAS WIDELY AVAILABLE ON A WEBSITE: HTTPS://CUMBERLANDHEALTHCARE.COM/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES/THE FAP APPLICATION FORM WAS WIDELY AVAILABLE ON A WEBSITE: HTTPS://CUMBERLANDHEALTHCARE.COM/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES/A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE ON A WEBSITE: HTTPS://CUMBERLANDHEALTHCARE.COM/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES/
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - CUMBERLAND HEALTHCARE MEDICAL CLINIC
1110 7TH AVENUECUMBERLANDWI54829RURAL HEALTH CLINIC
2 - CUMBERLAND HEALTHCARE TURTLE LAKE CENTER
632 US HWY 8TURTLE LAKEWI54889RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7: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 DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST HOSPITAL REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. THE COSTING METHODOLOGY USED IS BASED ON MEDICARE COST REPORTING METHODS.
PART I, LINE 7G:THE COST OF SUBSIDIZED SERVICES IS BASED ON COST ALLOCATIONS FROM THE MEDICARE COST REPORT. ALLOWABLE COSTS ARE ASSIGNED DIRECTLY TO DEPARTMENTS THROUGHOUT THE YEAR AND THEN THE COST REPORT USES THE ALLOCATION METHODOLOGY TO ASSIGN ALL OTHER COSTS TO CALCULATE SERVICE LINE COSTS. SUBSIDIZED HEALTH SERVICES INCLUDED THE CLINICS AND THE EMERGENCY ROOM DEPARTMENT. THESE SERVICES ARE UNAVAILABLE TO MEMBERS OF THE COMMUNITY OTHER THAN THROUGH CUMBERLAND MEMORIAL HOSPITAL. IT HAS BEEN THE GOAL OF CUMBERLAND MEMORIAL HOSPITAL TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY.
PART II, COMMUNITY BUILDING ACTIVITIES:CUMBERLAND MEMORIAL HOSPITAL PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE HOSPITAL BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. SEE PART 1, LINE 7 FOR THE CALCULATED COST OF PROVIDING COMMUNITY SERVICES. CUMBERLAND MEMORIAL HOSPITAL, LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, THE HOSPITAL PROVIDES LOCAL ACCESS TO MANY HEALTH SERVICES: AMBULANCE SERVICES, BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES & URGENT CARE, EXTENDED CARE, INPATIENT CARE, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SLEEP CENTER, SPEECH, AND SURGICAL SERVICES.
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 DEBTS, DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE FISCAL YEAR TO ESTIMATE THE COST OF THE CARE OF PATIENTS THAT HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE HOSPITAL ALSO PROVIDES DISCOUNTS TO ELIGIBLE UNINSURED OR UNDERINSURED PATIENTS UNDER ITS CHARITABLE CARE POLICY. THESE AMOUNTS ARE INCLUDED IN THE CONTRACTUAL ADJUSTMENTS 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 OR UNDERINSURED 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 HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. MANY TIMES PATIENTS ARE UNABLE TO COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH THE HOSPITAL PROVIDES THIS INFORMATION TO ALL PATIENTS AND ASSISTANCE WITH THE APPLICATIONS. DUE TO NO RESPONSES FROM SOME PATIENTS, A SMALL AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE.
PART III, LINE 4:PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY: IN EVALUATING THE COLLECTABILITY OF PATIENT 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 UNCOLLECTIBLE AMOUNTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET BEEN 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:CUMBERLAND MEMORIAL HOSPITAL IS DESIGNATED A CRITICAL ACCESS HOSPITAL AND AS SUCH A PORTION OF ITS REVENUE IS 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 AT CUMBERLAND MEMORIAL HOSPITAL OR AMBULANCE SERVICES. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT METHODOLOGY AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND AMBULANCE 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 CUMBERLAND MEMORIAL HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDING AREA OF CUMBERLAND, WISCONSIN. THE COSTING METHOD USED ABOVE FOR IRS 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 REVENUE (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 ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTH CARE 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:UNDER THE HOSPITAL'S COLLECTION AND CHARITABLE CARE POLICIES, CUMBERLAND MEMORIAL HOSPITAL MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE HOSPITAL'S CHARITABLE CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. ALL INPATIENT SELF-PAY ADMISSIONS ARE SCREENED BY THE HOSPITAL'S FINANCIAL COUNSELOR TO ALLOW THESE PATIENTS THE ABILITY TO COMPLETE THEIR APPLICATION DURING THEIR STAY AT THE HOSPITAL, DEPENDING UPON THE PATIENT'S CONDITION, THE PATIENT'S RESPONSIBLE PARTY MAY BE CONTACTED TO COMPLETE AND RETURN THE FORMS AT A LATER TIME WHEN THEIR CARE ALLOWS THIS COMPLETION. DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE HOSPITAL'S COLLECTION POLICES AS WELL AS THE CHARITY AND COMMUNITY CARE PROGRAM TO ALLOW PATENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM. INCLUDED IN THE POLICY, IT IS ALSO NOTED THAT THE HOSPITAL RESERVES THE RIGHT TO MAKE OR GRANT ADDITIONAL CHARITY CARE ON A CASE-BY-CASE BASIS.
PART VI, LINE 2:IN 2020 CUMBERLAND HEALTHCARE ACHIEVED CDC RECOGNITION AS A DIABETES PREVENTION PROGRAM ORGANIZED BY DISTANCE LEARNING CLASS TYPE. OUR DIABETIC PROGRAM CONTINUES WITH CLASSES AND PARTICIPANTS THAT INCLUDES A DIABETES PREVENTION PROGRAM. THIS IS LED BY NUMEROUS RNS AND RD'S. WE NOW OFFER THIS PROGRAM VIRTUALLY OR IN PERSON TO MEET THE NEEDS OF OUR COMMUNITY. THE PANDEMIC HAS CERTAINLY MADE THINGS MORE CHALLENGING THESE LAST FEW YEARS. WE ARE IN OUR FINAL YEAR OF THE DIABETIC GRANT WE RECEIVED. THIS GRANT HAS ALLOWED US TO PROVIDE STAFF TIME, SUPPLIES, AND EQUIPMENT (IPADS) FOR DIABETIC EDUCATION. WE CONTINUE TO BRING IPADS TO AREA HEALTH AND WELLNESS FAIRS FOR DIABETIC PREVENTION TESTING. WE ARE ALSO STILL USING FUNDS FROM THE MENTAL HEALTH GRANT - TRYING TO DO OUTREACH AND BRING MORE AWARENESS TO MENTAL HEALTH BY VISITING AREA SCHOOL. WE OFFERED OUR ANNUAL KNOW YOUR NUMBERS HEALTH FAIR IN A MODIFIED WAY SPRING 2021 AND BACK TO NORMAL IN 2022. THIS CONTINUES WITH FREE HEALTH SCREENINGS FOR THE COMMUNITY OFFERING FREE BLOOD WORK. WE CONTINUE TO GET SPECIALISTS TO COME TO OUR FACILITY TO PROVIDE AS MANY SERVICES LOCALLY AS WE CAN. IN LATE 2021-2022 WE RECEIVED A GRANT TO BE USED FOR MENTAL HEALTH AND ALLOW US TO REACH OUT TO OUR SURROUNDING COMMUNITY EASIER. WE DEVELOPED A PLAN TO BE VISIBLE IN OUR AREA SCHOOLS TO INCREASE THE AWARENESS OF OUR MENTAL HEALTH PROVIDERS AS A RESOURCE AS WELL AS EDUCATE THE AREA YOUTH ABOUT MENTAL HEALTH, DEPRESSION AND SUICIDE. WE HAVE STARTED TRANSITIONAL CARE MANAGEMENT A PATIENT-CENTERED PROGRAM AS PATIENT'S TRANSITION FROM THE HOSPITAL TO HOME WITH A GOAL FOR THEM TO BE SUCCESSFUL AND SAFE AND DECREASE THE CHANCES OF READMISSION. THIS ALLOWS PATIENTS DIRECT ACCESS TO THEIR PRIMARY CARE PROVIDER REDUCING ER VISITS AND COORDINATES THEIR CARE AND FOLLOW-UP. IN 2022 WE LAUNCHED CHRONIC CARE MANAGEMENT WITH AN RN COORDINATOR THAT FOLLOWS THOSE PATIENTS WITH CHRONIC DISEASE AND HEALTH CONDITIONS SUCH AS DIABETES, HIGH BLOOD PRESSURE MULTIPLE SCLEROSIS, ETC., TO HELP MOTIVATE PATIENTS TO PERSIST IN THERAPY AND INTERVENTIONS FOR A BETTER QUALITY OF LIFE.
PART VI, LINE 3:IF A PATIENT IS IDENTIFIED AS UNINSURED, CUMBERLAND HEALTHCARE STAFF WORKS WITH THE PATIENT AND/OR THEIR FAMILY TO DETERMINE IF THEY ARE ELIGIBLE FOR ANY TYPE OF GOVERNMENT PROGRAMS OR QUALIFY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. ASSISTANCE INFORMATION IS ALSO PUBLICIZED ON OUR WEBSITE.
PART VI, LINE 4:THE HOSPITAL SERVES THE COMMUNITIES OF CUMBERLAND, TURTLE LAKE, AND ALMENA, WI AND SURROUNDING COMMUNITIES WITHIN A 20-MILE RADIUS. THERE ARE THREE OTHER HOSPITALS LOCATED IN THE RURAL AREA THAT THE ORGANIZATION SERVES. WE ALSO HAVE A SATELLITE CLINIC IN TURTLE LAKE WHICH OFFERS FAMILY PRACTICE AND REHAB SERVICES.
PART VI, LINE 5:A MAJORITY OF OUR ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. OUR ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. WE ALSO PARTICIPATE IN COMMUNITY HEALTH FAIRS AND PROVIDE SERVICE AT SPORTING EVENTS. SURPLUS FUNDS ARE INVESTED BACK INTO THE FACILITY AND ITS EQUIPMENT TO ENSURE THE NEEDED SERVICES ARE CONTINUED TO BE PROVIDED IN THIS COMMUNITY.
PART VI, LINE 6:N/A
PART VI, LINE 7, REPORTS FILED WITH STATESWI

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 (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
DR AMY BAIR
GENERAL SURGEON$402,662$0$0$0$131$0$11,711$0$12,420$0$426,924$0$426,794$0
DR CRAIG JENNINGS
PHYSICIAN$241,800$0$78,332$0$211$0$4,773$0$35,416$0$360,532$0$360,321$0
MICHAEL GUTSCH
CEO$237,759$0$31,492$0$4,488$0$7,815$0$25,376$0$306,930$0$306,783$0
DR KIMBERLY AUCOIN
PHYSICIAN$250,000$0$23,650$0$251$0$4,469$0$2,192$0$280,562$0$280,311$0
DONALD FULLERTON
CRNA$223,856$0$1,500$0$8$0$8,007$0$29,184$0$262,555$0$262,530$0
STEFANIE RINEHARDT
CRNA$205,876$0$1,500$0$88$0$6,476$0$35,708$0$249,648$0$249,542$0
ROBERT LINDBERG
COO$155,574$0$14,030$0$108$0$29,749$0$0$0$199,461$0$0$0
ANGIE MARTENS
CFO$158,047$0$15,248$0$358$0$6,777$0$2,192$0$182,622$0$182,246$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE RETURN IS REVIEWED BY THE CHIEF FINANCIAL OFFICER AND A FINAL DRAFT IS GIVEN TO THE BOARD MEMBERS OF CUMBERLAND MEMORIAL HOSPITAL. UPON APPROVAL FROM THE BOARD MEMBERS, THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE (IRS).
FORM 990, PART VI, SECTION B, LINE 12CCUMBERLAND MEMORIAL HOSPITAL REQUIRES ITS BOARD MEMBERS TO SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. OFFICERS AND KEY EMPLOYEES OF CUMBERLAND MEMORIAL HOSPITAL & EXTENDED CARE UNIT, INC. SIGN A CODE OF CONDUCT STATEMENT. IN THE CODE OF CONDUCT STATEMENT, IT MENTIONS THE CONFLICT OF INTEREST. ANY PERSON THAT BELIEVES TO HAVE A CONFLICT SHOULD DISCLOSE AS A MATTER OF RECORD TO THE BOARD ON AN ANNUAL BASIS OR AS THE INTEREST DEVELOPS AND BEFORE IT IS CONSUMMATED. ANY DIRECTOR HAVING A CONFLICT MAY NOT VOTE OR USE PERSONAL INFLUENCE ON THE MATTER. THE DIRECTOR CAN STATE THEIR POSITION ON THE MATTER BEFORE ABSTAINING FROM VOTE.
FORM 990, PART VI, SECTION B, LINE 15EXECUTIVE SALARIES ARE SET ANNUALLY CONSIDERING COMPENSATION LEVELS AT SIMILARLY SITUATED ORGANIZATIONS (TYPICALLY NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS IN SIMILAR REVENUE CATEGORIES). THE BOARD OF DIRECTORS IS RESPONSIBLE FOR SETTING THE SALARY OF THE CEO BASED ON JOB PERFORMANCE. THE BOARD RELIES UPON COMPARABILITY DATA DEVELOPED BY OUTSIDE CONSULTANTS TO SUPPORT ITS DECISION-MAKING PROCESS AND TO ENSURE COMPETITIVE SALARY LEVELS. ALL OTHER NON-UNION WAGES ARE REVIEWED SEMI-ANNUALLY IN COMPARISON TO THE RURAL WISCONSIN HEALTH COOPERATIVE WAGE SURVEY. THIS WAGE SURVEY INCLUDES WAGE DATA OF 27 RURAL HEALTH CARE ORGANIZATIONS. THE GOAL OF THE ORGANIZATION IS TO REMAIN WITHIN THE WAGE SURVEY AVERAGES, BASED ON YEARS OF SERVICE TO BE COMPETITIVE WITH SIMILAR ORGANIZATIONS.
FORM 990, PART VI, SECTION C, LINE 19CUMBERLAND MEMORIAL HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GOTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,656,947. MANAGEMENT AND GENERAL EXPENSES 330,440. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,987,387. CONTRACTED ER PHYSICIANS: PROGRAM SERVICE EXPENSES 740,321. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 740,321. CONTRACTED - PHARMACY: PROGRAM SERVICE EXPENSES 445,675. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 445,675. CONTRACTED RADIOLOGY/NUCLEAR MEDICINE SERVICES: PROGRAM SERVICE EXPENSES 451,305. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 451,305. CONTRACTED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 1,054,247. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,054,247.
FORM 990, PART XII, LINE 2C, AUDIT OVERSIGHT:CUMBERLAND MEMORIAL HOSPITAL'S ENTIRE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THE AUDITED FINANCIAL STATEMENTS ARE REVIEWED BY THE BOARD OF DIRECTORS ANNUALLY AND ANY QUESTIONS OR CONCERNS REGARDING THE STATEMENTS ARE ADDRESSED BY THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.