HOLY FAMILY MEMORIAL INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- HOLY FAMILY MEMORIAL INC (EIN 39-0806395)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-11
- IRS object ID
- 202321319349303812
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-11T11:24:06-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 191 WEST NATIONWIDE BLVD SUITE 500 | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 432152568 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390806395 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLY FAMILY MEMORIAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOLY | BusinessNameControlTxt |
| Phone | 9203202011 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2300 WESTERN AVENUE PO BOX 1450 | AddressLine1Txt |
| City | MANITOWOC | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 542211450 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ALICIA M MAITLAND | PersonNm |
| Person Title | SVP - FINANCE | PersonTitleTxt |
| Phone | 9203202011 | PhoneNum |
| Signature | 2023-05-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ALICIA | PersonFirstNm |
| Person Last | MAITLAND | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MOLLIE P LONGHOUSE | PreparerPersonNm |
| PTIN | P00294881 | PTIN |
| Phone | 6142492300 | PhoneNum |
| Preparation | 2023-05-09 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEVE LITTLE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2300 WESTERN AVENUE PO BOX 1450 | AddressLine1Txt |
| City | MANITOWOC | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 542211450 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $112,060,761 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HFMHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1899 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | HOLY FAMILY MEMORIAL IS A NETWORK OF PROFESSIONALS WHO, ROOTED IN THE HEALING MINISTRY OF JESUS CHRIST, PROVIDE SERVICES TO HELP INDIVIDUALS ACHIEVE HEALTHIER LIVES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 180 | TotalVolunteersCnt |
| Total Gross UBI | $93,262 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $16,697 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $46,893 | PYContributionsGrantsAmt |
| CY Contributions Grants | $87,320 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $48,806,173 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $101,866,434 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,864,092 | PYInvestmentIncomeAmt |
| CY Investment Income | $113,981 | CYInvestmentIncomeAmt |
| PY Other Revenue | $111,450 | PYOtherRevenueAmt |
| CY Other Revenue | $8,846,407 | CYOtherRevenueAmt |
| PY Total Revenue | $51,828,608 | PYTotalRevenueAmt |
| CY Total Revenue | $110,914,142 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $6,309 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $127,113 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $33,466,946 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $77,882,350 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $235 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $28,423,236 | PYOtherExpensesAmt |
| CY Other Expenses | $68,476,115 | CYOtherExpensesAmt |
| PY Total Expenses | $61,896,491 | PYTotalExpensesAmt |
| CY Total Expenses | $146,485,578 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$10,067,883 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$35,571,436 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $64,042,070 | TotalAssetsBOYAmt |
| Total Assets EOY | $47,324,620 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $22,964,988 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,191,501 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $41,077,082 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $37,133,119 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | HOLY FAMILY MEMORIAL IS A NETWORK OF HEALTH PROFESSIONALS WHO, ROOTED IN THE HEALING MINISTRY OF JESUS CHRIST, PROVIDE SERVICES TO HELP INDIVIDUALS AND OUR COMMUNITIES ACHIEVE HEALTHIER LIVES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $73,604,210 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $73,785,306 | RevenueAmt |
| Desc | SEE SCHEDULE O - OUTPATIENT SERVICES | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $23,051,238 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $23,131,117 | RevenueAmt |
| Desc | SEE SCHEDULE O - INPATIENT SERVICES | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,839,977 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $4,856,749 | RevenueAmt |
| Desc | SEE SCHEDULE O - EMERGENCY SERVICES | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,762,714 | ExpenseAmt |
| Grant | $127,113 | GrantAmt |
| Revenue | $8,682,432 | RevenueAmt |
| Desc | ALL OTHER REVENUE:INTERCOMPANY REVENUE: REVENUE THAT ORIGINALLY CAME FROM PATIENT ACTIVITY THAT WAS MOVED BETWEEN RELATED FROEDTERT COMPANIES DUE TO COMPANY RESTRUCTURING;OTHER DEPARTMENT REVENUE: REVENUE DERIVED FROM A VARIETY OF SERVICES AND ACTIVITY THAT SUPPORTS DIRECTLY OR INDIRECTLY THE PROVISION OF PATIENT CARE WITHIN THE FACILITY. INCLUDED IN THIS CATEGORY ARE ATHLETIC TRAINER SERVICES, FITNESS DEVELOPMENT, WORKFORCE HEALTH, AND NUTRITION SERVICES;CAFETERIA: CAFETERIA RECEIPTS;ALL OTHER REVENUE: CONTAINS REBATES AND INVENTORY DISCOUNTS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $8,762,714 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $127,113 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $8,682,432 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $110,258,139 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 167 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | 0 | Form8899Filedind |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| DAF Excess Business Holdings | 0 | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | 0 | TaxableDistributionsInd |
| Distribution To Donor | 0 | DistributionToDonorInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID DIRKSMEYER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4147770929 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N74 W12501 LEATHERWOOD CT | AddressLine1Txt |
| City | MENOMONEE FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53051 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| MARK BEHL | |||||||||
| DIRECTOR & EVP/FH COO | 1.00 | 49.00 | Yes (X) | $0 | $1,424,699 | $200,708 | |||
| MICHELLE L BIRSCHBACH | |||||||||
| CO-CHAIR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MATTHEW L CAMPBELL MD | |||||||||
| DIRECTOR | 50.00 | 0.00 | Yes (X) | $63,629 | $366,187 | $42,682 | |||
| CANDICE GIESEN | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MILAN JORDAN MD | |||||||||
| DIRECTOR | 50.00 | 0.00 | Yes (X) | $64,038 | $352,741 | $45,073 | |||
| MARILYN A KAUFMANN PHD RN | |||||||||
| CHAIR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| SISTER NANCY KINATE | |||||||||
| SECRETARY | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| CHARLES KRUEGER | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| STEVEN LITTLE | |||||||||
| SR. VP & PRESIDENT | 50.00 | 0.00 | Yes (X) | $0 | $602,003 | $71,713 | Yes (X) | ||
| SISTER MARY FRANCES MAHER | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| GENEVIEVE SHIELDS | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS VEESER | |||||||||
| CHIEF NURSING OFFICER | 50.00 | 0.00 | Yes (X) | $34,841 | $186,095 | $69,612 | |||
| KENLYN T GRETZ | |||||||||
| DIRECTOR (TERMED 2-2022) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JEFFREY VAN DE KREEKE | |||||||||
| TREASURER | 1.00 | 49.00 | $0 | $594,531 | $34,997 | Yes (X) | |||
| RYAN M DOPIRAK MD | |||||||||
| PHYSICIAN PROVIDER | 50.00 | 0.00 | $116,042 | $716,820 | $50,799 | Yes (X) | |||
| RICHARD MANOS MD | |||||||||
| PHYSICIAN PROVIDER | 50.00 | 0.00 | $118,874 | $653,583 | $28,870 | Yes (X) | |||
| EDWARD L SMITH MD | |||||||||
| PHYSICIAN PROVIDER | 50.00 | 0.00 | $101,693 | $604,774 | $48,998 | Yes (X) | |||
| BRETT W NORELL | |||||||||
| FORMER OFFICER | 50.00 | 0.00 | $75,940 | $579,478 | $38,227 | Yes (X) | |||
| TROY D DAY | |||||||||
| FORMER OFFICER | 50.00 | 0.00 | $44,767 | $444,197 | $50,560 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $619,824 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,525,108 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $682,239 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| XTEND HEALTHCARE LLC | |||||
| 90 VOLUNTEER DR STE 200 | HENDERSONVILLE | TN | 37075 | BILLING SERVICES | $3,907,054 |
| RIGHTSOURCING INC | |||||
| PO BOX 515743 | LOS ANGELES | CA | 900515118 | STAFFING SERVICES | $1,906,861 |
| MEDICAL SOLUTIONS LLC | |||||
| 1010 N 102ND ST STE 300 | OMAHA | NE | 68114 | STAFFING SERVICES | $1,781,224 |
| BELLIN MEMORIAL HOSPITAL INC | |||||
| 1630 COMMANCHE AVE | GREEN BAY | WI | 54313 | PROFESSIONAL SVCS | $902,295 |
| COMPLETERX LTD | |||||
| 3200 WILCREST DR STE 250 | HOUSTON | TX | 77042 | PHARMACY SERVICES | $849,167 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 23 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $3,720 | FundraisingAmt |
| All Other Contributions | $83,600 | AllOtherContributionsAmt |
| Total Contributions | $87,320 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| OUTPATIENT REVENUE | 900099 | $73,785,306 | $73,785,306 | |
| INPATIENT REVENUE | 900099 | $23,131,117 | $23,131,117 | |
| EMERGENCY/TRAUMA REVENUE | 900099 | $4,856,749 | $4,856,749 | |
| LAB REFERRAL | 621500 | $93,262 | $93,262 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $101,866,434 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $88,103 | TotalRevenueColumnAmt |
| Exclusion | $88,103 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $143,507 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $143,507 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $143,507 | TotalRevenueColumnAmt |
| Exclusion | $143,507 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,163,715 | SecuritiesAmt |
| Other | $1,060 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,106,794 | SecuritiesAmt |
| Other | $32,103 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $56,921 | SecuritiesAmt |
| Other | -$31,043 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,878 | TotalRevenueColumnAmt |
| Exclusion | $25,878 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $28,190 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $3,720 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $7,722 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,468 | TotalRevenueColumnAmt |
| Exclusion | $20,468 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INTERCOMPANY REVENUE | 900099 | $7,089,442 | $7,089,442 |
| OTHER DEPARTMENT REVENUE | 900099 | $1,201,637 | $1,201,637 |
| CAFETERIA | 722514 | $297,643 | $297,643 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $93,710 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $93,710 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $8,682,432 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $110,914,142 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $110,455,604 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $93,262 | UnrelatedBusinessRevenueAmt |
| Exclusion | $277,956 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,265 | TotalAmt |
| Program Services | $110,265 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,848 | TotalAmt |
| Program Services | $16,848 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,388,362 | TotalAmt |
| Program Services | $56,982,231 | ProgramServicesAmt |
| Management And General | $5,406,131 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $731,987 | TotalAmt |
| Program Services | $589,945 | ProgramServicesAmt |
| Management And General | $142,042 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,809,064 | TotalAmt |
| Program Services | $6,812,888 | ProgramServicesAmt |
| Management And General | $3,996,176 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,952,937 | TotalAmt |
| Program Services | $3,558,551 | ProgramServicesAmt |
| Management And General | $394,386 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,656 | TotalAmt |
| Management And General | $151,656 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,937,292 | TotalAmt |
| Program Services | $14,310,704 | ProgramServicesAmt |
| Management And General | $15,626,440 | ManagementAndGeneralAmt |
| Fundraising | $148 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $316,514 | TotalAmt |
| Program Services | $27,903 | ProgramServicesAmt |
| Management And General | $288,611 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $712,961 | TotalAmt |
| Program Services | $325,533 | ProgramServicesAmt |
| Management And General | $387,428 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,377,823 | TotalAmt |
| Program Services | $1,543,865 | ProgramServicesAmt |
| Management And General | $5,833,884 | ManagementAndGeneralAmt |
| Fundraising | $74 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,112,571 | TotalAmt |
| Program Services | $1,013,833 | ProgramServicesAmt |
| Management And General | $1,098,738 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,227 | TotalAmt |
| Program Services | $28,586 | ProgramServicesAmt |
| Management And General | $41,641 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,109 | TotalAmt |
| Program Services | $153,175 | ProgramServicesAmt |
| Management And General | $74,934 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,030,670 | TotalAmt |
| Program Services | $2,548,564 | ProgramServicesAmt |
| Management And General | $1,482,093 | ManagementAndGeneralAmt |
| Fundraising | $13 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,130 | TotalAmt |
| Program Services | $78,095 | ProgramServicesAmt |
| Management And General | $14,035 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $19,535,838 | $19,230,813 | $305,025 |
| STATE ASSESSMENT | $2,025,324 | $2,025,324 | |
| DUES & LICENSES | $1,107,046 | $519,099 | $587,947 |
| RECRUITMENT, OTHER DIRE | $698,780 | $334,512 | $364,268 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,174 | TotalAmt |
| Program Services | $47,405 | ProgramServicesAmt |
| Management And General | $31,769 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,485,578 | TotalAmt |
| Program Services | $110,258,139 | ProgramServicesAmt |
| Management And General | $36,227,204 | ManagementAndGeneralAmt |
| Fundraising | $235 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,625,058 | BOYAmt |
| EOY | -$4,917,209 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,386,170 | BOYAmt |
| EOY | $10,502,367 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,983,857 | BOYAmt |
| EOY | $1,444,574 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,652,295 | BOYAmt |
| EOY | $1,174,925 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $31,834,430 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,053,744 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,997,630 | BOYAmt |
| EOY | $26,780,686 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,222,060 | BOYAmt |
| EOY | $5,931,519 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $175,000 | BOYAmt |
| EOY | $6,407,758 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,042,070 | BOYAmt |
| EOY | $47,324,620 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,578,384 | BOYAmt |
| EOY | $9,772,058 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,192 | BOYAmt |
| EOY | $69,236 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,310,412 | BOYAmt |
| EOY | $350,207 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,964,988 | BOYAmt |
| EOY | $10,191,501 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,102,195 | BOYAmt |
| EOY | $33,633,887 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,974,887 | BOYAmt |
| EOY | $3,499,232 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,077,082 | BOYAmt |
| EOY | $37,133,119 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,042,070 | BOYAmt |
| EOY | $47,324,620 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$35,571,436 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$435,807 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$638,855 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $32,702,135 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,974,887 | BeginningYearBalanceAmt |
| Contributions | $70,890 | ContributionsAmt |
| Investment Earnings Or Losses | -$487,031 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $59,513 | OtherExpendituresAmt |
| End Year Balance | $3,499,233 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,888,220 | BeginningYearBalanceAmt |
| Contributions | $14,813 | ContributionsAmt |
| Investment Earnings Or Losses | $111,690 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $39,836 | OtherExpendituresAmt |
| End Year Balance | $3,974,887 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,792,351 | BeginningYearBalanceAmt |
| Contributions | $170,642 | ContributionsAmt |
| Investment Earnings Or Losses | $265,013 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $339,786 | OtherExpendituresAmt |
| End Year Balance | $3,888,220 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,157,405 | BeginningYearBalanceAmt |
| Contributions | $726,675 | ContributionsAmt |
| Investment Earnings Or Losses | $264,841 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $356,570 | OtherExpendituresAmt |
| End Year Balance | $3,792,351 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,160,846 | BeginningYearBalanceAmt |
| Contributions | $203,946 | ContributionsAmt |
| Investment Earnings Or Losses | -$91,795 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $115,592 | OtherExpendituresAmt |
| End Year Balance | $3,157,405 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.87400 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.09700 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.02900 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,420,931 | OtherCostOrOtherBasisAmt |
| Book Value | $7,420,931 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,476,460 | OtherCostOrOtherBasisAmt |
| Depreciation | $262,399 | DepreciationAmt |
| Book Value | $5,214,061 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,462,634 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,726,099 | DepreciationAmt |
| Book Value | $12,736,535 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,474,405 | OtherCostOrOtherBasisAmt |
| Depreciation | $65,246 | DepreciationAmt |
| Book Value | $1,409,159 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $26,780,686 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| BOARD DESIGNATED - OTHER | $4,042,846 |
| MISCELLANEOUS A/R | $1,792,381 |
| DUE FROM AFFILIATES | $572,531 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $6,407,758 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LONG TERM OPERATING LEASE OBLI | Desc |
| Amt | $350,207 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $350,207 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | HOLY FAMILY MEMORIAL'S ENDOWMENT FUNDS WERE ESTABLISHED TO PROVIDE FINANCIAL SUPPORT ON AN ONGOING BASIS TO MEET THE CURRENT AND FUTURE NEEDS OF HOLY FAMILY MEMORIAL AND THE PEOPLE IT SERVES. FUNDS ARE USED FOR CAPITAL EQUIPMENT, MAJOR BUILDING IMPROVEMENTS, PROGRAM DEVELOPMENT, AND OPERATIONS. |
| PART X, LINE 2: | THE SYSTEM APPLIES ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. ASC TOPIC 740 PRESCRIBES A MORE-LIKELY THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC TOPIC 740, TAX POSITIONS ARE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. AS OF JUNE 30, 2022 AND 2021, THE SYSTEM DOES NOT HAVE AN ASSET OR LIABILITY RECORDED FOR UNRECOGNIZED TAX POSITIONS. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | SAMARITAN DAY | Event1Nm |
| Gross Receipts Event1 | $23,325 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $3,720 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $19,605 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $7,587 | OtherDirectExpensesEvent1Amt |
| Event2 | LOVE LIGHTS | Event2Nm |
| Gross Receipts Event2 | $8,585 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $8,585 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $135 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $31,910 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $3,720 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $28,190 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $7,722 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $7,722 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $20,468 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $276,471 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $276,471 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,523,014 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,587,332 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,935,682 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07470 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,799,485 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,587,332 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,212,153 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07660 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 17 | ActivitiesOrProgramsCnt |
| Persons Served | 6950 | PersonsServedCnt |
| Total Community Benefit Expns | $192,071 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $192,071 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 113 | PersonsServedCnt |
| Total Community Benefit Expns | $117,214 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $117,214 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 3122 | PersonsServedCnt |
| Total Community Benefit Expns | $144,652 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $144,652 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 31 | ActivitiesOrProgramsCnt |
| Persons Served | 10185 | PersonsServedCnt |
| Total Community Benefit Expns | $453,937 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $453,937 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 31 | ActivitiesOrProgramsCnt |
| Persons Served | 10185 | PersonsServedCnt |
| Total Community Benefit Expns | $18,253,422 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,587,332 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,666,090 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07970 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 75 | PersonsServedCnt |
| Total Community Benefit Expns | $9,760 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,760 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $2,327 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,327 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 6 | PersonsServedCnt |
| Total Community Benefit Expns | $961 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $961 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 81 | PersonsServedCnt |
| Total Community Benefit Expns | $13,048 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $13,048 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,959,532 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $16,741,196 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $23,285,130 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$6,543,934 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 NONE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLY FAMILY MEMORIAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2300 WESTERN AVENUE PO BOX 1450 | AddressLine1Txt |
| City | MANITOWOC | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 542211450 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.HFMHEALTH.ORG | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLY FAMILY MEMORIAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | HEALTHIESTMC.ORG; MANITOWOCCOUNTYWI.GOV/ | OtherWebsiteURLTxt |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 250.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.HFMHEALTH.ORG/COMMUNITY-CARE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SAME AS 16B | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 5 | COMMUNITY HEALTH NEEDS ASSESSMENT:IN 2022, A CHNA WAS CONDUCTED TO 1) DETERMINE CURRENT COMMUNITY HEALTH NEEDS IN MANITOWOC COUNTY, 2) GATHER INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY AND IDENTIFY COMMUNITY ASSETS, 3) IDENTIFY AND PRIORITIZE SIGNIFICANT HEALTH NEEDS, AND 4) DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS THE PRIORITIZED HEALTH NEEDS. HOLY FAMILY MEMORIAL ASSESSED THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A COMPREHENSIVE DATA COLLECTION PROCESS FROM A NUMBER OF KEY SOURCES. DATA AND RESEARCH INCLUDED INFORMATION FROM COMMUNITY MEMBERS, PUBLIC HEALTH OFFICIALS, COMMUNITY LEADERS/EXPERTS, AND NON-PROFIT ORGANIZATIONS REPRESENTING VULNERABLE POPULATIONS IN OUR SERVICE AREA. INFORMATION/DATA SOURCES WERE COLLECTED AND TAKEN INTO CONSIDERATION FOR ASSESSING AND ADDRESSING COMMUNITY HEALTH NEEDS. THESE INCLUDED A COMMUNITY HEALTH SURVEY, KEY STAKEHOLDER INTERVIEWS, SECONDARY DATA ANALYSIS AND INTERNAL HOSPITAL DATA ANALYSIS. FOR THE TAX YEAR ENDED JUNE 30, 2022, THIS INCLUDES THE TIME PERIOD REPORTED IN THIS FORM 990, HOLY FAMILY MEMORIAL ADDRESSED THE SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN ITS 2019 CHNA AND IN WHICH THE IMPLEMENTATION STRATEGY WAS ADOPTED FOR FISCAL YEARS 2020, 2021, AND 2022. AS OF MARCH 1, 2021, BFHFM, LLC OWNS 80% OF HFM AS A CORPORATE MEMBER. FROEDTERT HEALTH INC OWNS 100% OF BFHFM, LLC. FROEDTERT HEALTH HAS UNTIL JUNE, 30, 2023 TO BE IN FULL COMPLIANCE WITH IRC 501(R)(3).IN 2019, A CHNA WAS CONDUCTED TO 1) DETERMINE CURRENT COMMUNITY HEALTH NEEDS IN MANITOWOC COUNTY, 2) GATHER INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY AND IDENTIFY COMMUNITY ASSETS, 3) IDENTIFY AND PRIORITIZE SIGNIFICANT HEALTH NEEDS, AND 4) DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS THE PRIORITIZED HEALTH NEEDS. HOLY FAMILY MEMORIAL ASSESSED THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A COMPREHENSIVE DATA COLLECTION PROCESS FROM A NUMBER OF KEY SOURCES. DATA AND RESEARCH INCLUDED INFORMATION FROM COMMUNITY MEMBERS, PUBLIC HEALTH OFFICIALS, COMMUNITY LEADERS/EXPERTS, AND NON-PROFIT ORGANIZATIONS REPRESENTING VULNERABLE POPULATIONS IN OUR SERVICE AREA. THE FOLLOWING INFORMATION/DATA SOURCES WAS COLLECTED AND TAKEN INTO CONSIDERATION FOR ASSESSING AND ADDRESSING COMMUNITY HEALTH NEEDS:COMMUNITY HEALTH SURVEY: USING THE CENTER FOR DISEASE CONTROL'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), A TELEPHONE-BASED SURVEY OF 400 RESIDENTS WAS CONDUCTED BY HOLY FAMILY MEMORIAL IN COLLABORATION WITH AURORA HEALTH CARE, LAKESHORE CAP, LAKESHORE COMMUNITY HEALTH CENTER, UNITED WAY MANITOWOC COUNTY AND THE MANITOWOC COUNTY HEALTH DEPARTMENT. THE FULL REPORT OF THIS SURVEY CAN BE FOUND AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. KEY INFORMANT INTERVIEWS: HOLY FAMILY MEMORIAL LEADERS CONDUCTED 31 IN-PERSON INTERVIEWS WITH 32 COMMUNITY LEADERS OF VARIOUS SCHOOL DISTRICTS, NON-PROFIT ORGANIZATIONS, HEALTH & HUMAN SERVICE DEPARTMENT AND BUSINESS LEADERS. THE FULL KEY INFORMANT RESULTS CAN BE FOUND AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. COMMUNITY PARTNER/AGENCY REPORTS: TO BETTER UNDERSTAND THE NEEDS OF OUR UNDERSERVED POPULATIONS, HOLY FAMILY MEMORIAL OBTAINED IMPORTANT DATA AND TRENDS FROM PARTNER ORGANIZATIONS SUCH AS LAKESHORE COMMUNITY HEALTH CENTER, UNITED WAY MANITOWOC COUNTY ALICE REPORT, AND OTHERS TO SEEK IMPORTANT TRENDS, DEMOGRAPHIC DATA AND SERVICES TO PROVIDE AN INCLUSIVE VIEWPOINT OF COMMUNITY NEEDS FOR THESE UNREPRESENTED POPULATIONS.SECONDARY DATA REPORTS: UTILIZING MULTIPLE COUNTY AND COMMUNITY-BASED PUBLICLY AVAILABLE REPORTS, INFORMATION WAS GATHERED REGARDING: MORTALITY/MORBIDITY DATA, INJURY HOSPITALIZATIONS, EMERGENCY DEPARTMENT VISITS, MANITOWOC COUNTY HEALTH RANKINGS, PUBLIC SAFETY/CRIME REPORTS AND SOCIO-ECONOMIC DATA. A FULL SUMMARY OF SECONDARY DATA INFORMATION CAN BE FOUND AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. HOLY FAMILY MEMORIAL IS COMMITTED TO ADDRESSING COMMUNITY HEALTH NEEDS COLLABORATIVELY WITH LOCAL PARTNERS. HOLY FAMILY MEMORIAL USED THE FOLLOWING METHODS TO GAIN COMMUNITY INPUT FROM FEBRUARY THROUGH MARCH 2019 ON THE SIGNIFICANT HEALTH NEEDS OF THE HOLY FAMILY MEMORIAL'S COMMUNITY. THESE METHODS PROVIDED ADDITIONAL PERSPECTIVES ON HOW TO SELECT AND ADDRESS TOP HEALTH ISSUES FACING HOLY FAMILY MEMORIAL'S COMMUNITY.INPUT FROM COMMUNITY MEMBERS:KEY INFORMANT INTERVIEWS: KEY ORGANIZATIONS WITH SPECIFIC KNOWLEDGE AND INFORMATION RELEVANT TO THE SCOPE OF THE IDENTIFIED SIGNIFICANT HEALTH NEEDS ("INFORMANTS") IN HOLY FAMILY MEMORIAL'S COMMUNITY, INCLUDING MANITOWOC COUNTY, WERE IDENTIFIED BY ORGANIZATIONS AND PROFESSIONALS THAT REPRESENT THE BROAD NEEDS OF THE COMMUNITY AS WELL AS ORGANIZATIONS THAT SERVE LOW-INCOME AND UNDERSERVED POPULATIONS. THESE LOCAL PARTNERING ORGANIZATIONS ALSO INVITED THE INFORMANTS TO PARTICIPATE IN AND CONDUCT THE INTERVIEWS. THE INTERVIEWERS USED A STANDARD INTERVIEW SCRIPT THAT INCLUDED THE FOLLOWING ELEMENTS:RANKING OF UP TO FIVE PUBLIC HEALTH ISSUES, BASED ON THE FOCUS AREAS PRESENTED IN WISCONSIN'S STATE HEALTH PLAN, THAT ARE THE MOST IMPORTANT ISSUES FOR THE COUNTY; ANDFOR THOSE FIVE PUBLIC HEALTH ISSUES:-EXISTING STRATEGIES TO ADDRESS THE ISSUE,-BARRIERS AND CHALLENGES TO ADDRESSING THE ISSUE,-ADDITIONAL STRATEGIES NEEDED,-KEY GROUPS IN THE COMMUNITY THAT HOSPITALS SHOULD PARTNER WITH TO IMPROVE COMMUNITY HEALTH,-IDENTIFICATION OF SUBGROUPS OR SUBPOPULATIONS WHERE EFFORTS COULD BE TARGETED, AND-WAYS EFFORTS CAN BE TARGETED TOWARD EACH SUBGROUP OR SUBPOPULATION.UNDERSERVED POPULATION INPUT: HOLY FAMILY MEMORIAL IS DEDICATED TO REDUCING HEALTH DISPARITIES AND INPUT FROM COMMUNITY MEMBERS WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AND/OR ORGANIZATIONS THAT REPRESENT THOSE POPULATIONS ARE IMPORTANT IN ADDRESSING COMMUNITY HEALTH NEEDS. WITH THAT IN MIND, HOLY FAMILY MEMORIAL TOOK THE FOLLOWING STEPS TO GAIN INPUT:-COMMUNITY HEALTH SURVEY: WHEN APPROPRIATE, DATA WAS STRATIFIED BY GENDER, AGE, EDUCATION HOUSEHOLD INCOME LEVEL AND MARITAL STATUS.-KEY INFORMANT INTERVIEWS: THE KEY INFORMANT INTERVIEWS INCLUDED INPUT FROM MEMBERS OF ORGANIZATIONS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS.SUMMARY OF COMMUNITY MEMBER INPUT:TOP FIVE HEALTH ISSUES RANKED MOST CONSISTENTLY OR MOST OFTEN CITED FOR MANITOWOC COUNTY WERE: KEY INFORMANT INTERVIEWS FOR-MENTAL HEALTH,-SUBSTANCE USE AND ABUSE,-ALCOHOL ABUSE,-ADVERSE CHILDHOOD EXPERIENCES, AND-ACCESS TO HEALTH CARE.COMMUNITY HEALTH SURVEY:-ILLEGAL DRUG USE,-ALCOHOL USE OR ABUSE,-PRESCRIPTION OR OTC DRUG ABUSE,-ACCESS TO HEALTH CARE, AND-CHRONIC DISEASES.AFTER ADOPTION OF THE CHNA REPORT AND IMPLEMENTATION STRATEGY, HOLY FAMILY MEMORIAL PUBLICLY SHARES BOTH DOCUMENTS WITH COMMUNITY PARTNERS, KEY INFORMANTS, HOSPITAL BOARD MEMBERS, PUBLIC SCHOOLS, NON-PROFITS, HOSPITAL COALITION MEMBERS, THE MANITOWOC COUNTY HEALTH DEPARTMENT, AND THE GENERAL PUBLIC. DOCUMENTS ARE MADE AVAILABLE VIA EMAIL, HARD COPIES ARE MADE AVAILABLE AT APPLICABLE MEETINGS, AND ELECTRONIC COPIES ARE MADE AVAILABLE BY PDF FOR DOWNLOAD ON HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. FEEDBACK AND PUBLIC COMMENTS ARE ALWAYS WELCOMED AND ENCOURAGED, AND CAN BE PROVIDED THROUGH THE CONTACT FORM ON THE FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN WEBSITE AT HTTPS://WWW.FROEDTERT.COM/CONTACT, OR CONTACTING FROEDTERT HEALTH, INC.'S COMMUNITY ENGAGEMENT LEADERSHIP/STAFF WITH QUESTIONS AND CONCERNS BY CALLING 414-777-1926. HOLY FAMILY MEMORIAL RECEIVED NO COMMENTS OR ISSUES WITH THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY. |
| PART V, LINE 5(CONT) | MANITOWOC COUNTY KEY INFORMANT INTERVIEW ORGANIZATIONS:AGING AND DISABILITY RESOURCE CENTER OF THE LAKESHORE- PROVIDES INFORMATION, ASSISTANCE, AND ACCESS TO SERVICES AND COMMUNITY RESOURCES FOR SENIORS AND ADULTS WITH DISABILITIES;ASCEND SERVICES, INC- NONPROFIT THAT PROVIDES SERVICES TO INDIVIDUALS WITH EXCEPTION ABILITIES THROUGH COMMUNITY EXPERIENCES, EDUCATION AND EMPLOYMENT OPPORTUNITIES;CITY OF MANITOWOC- LOCAL GOVERNMENT;FIRST PRESBYTERIAN CHURCH- FAITH-BASED ORGANIZATION;UW-EXTENSION MANITOWOC COUNTY- DESIGNS EDUCATIONAL PROGRAMS FOCUSED ON AGRICULTURE, COMMUNITY DEVELOPMENT, HUMAN DEVELOPMENT & RELATIONSHIPS, NUTRITION EDUCATION, 4-H YOUTH DEVELOPMENT, AND POSITIVE YOUTH DEVELOPMENT;HOLY FAMILY MEMORIAL- HEALTH CARE ORGANIZATION;HOLY FAMILY MEMORIAL BEHAVIORAL HEALTH- DEPARTMENT THAT PROVIDES CARE TO INDIVIDUALS SEEKING BEHAVIORAL HEALTH SERVICES;HOPE HOUSE OF MANITOWOC COUNTY- NONPROFIT THAT PROVIDES SHELTER AND SUPPORTIVE SERVICES TO INDIVIDUALS AND FAMILIES EXPERIENCING HOMELESSNESS;IN COURAGE- NONPROFIT PROVIDING SERVICES FOR PEOPLE DEALING WITH DOMESTIC ABUSE;MANITOWOC COUNTY VETERANS SERVICES OFFICE- DEPARTMENT THAT PROVIDES SERVICES TO VETERANS;MANITOWOC COUNTY HEALTH DEPARTMENT- GOVERNMENT DEPARTMENT THAT PREVENTS DISEASE AND PROMOTES HEALTH;MANITOWOC COUNTY HUMAN SERVICES DEPARTMENT- PROVIDES COMMUNITY PROGRAMS AND SERVICES TO INDIVIDUALS AND FAMILIES CHALLENGED BY MENTAL HEALTH AND SUBSTANCE USE AND ABUSE;MANITOWOC PUBLIC SCHOOL DISTRICT- PROVIDES SERVICES FOR YOUTH;MANITOWOC-TWO RIVERS YMCA- NONPROFIT PROVIDING SERVICES THAT HELP PEOPLE IMPROVE THEIR HEALTH AND WELL-BEING;MARIBEL FOOD PANTRY- PROVIDES FOOD FOR LOW INCOME INDIVIDUALS & FAMILIES;LAKESHORE CAP- PROVIDES SERVICES TO HELP INDIVIDUALS AND FAMILIES ACHIEVE ECONOMIC SELF-SUFFICIENCY AND WELL-BEING;LAKESHORE TECHNICAL COLLEGE- HIGHER EDUCATION INSTITUTE;REEDSVILLE SCHOOL DISTRICT- PROVIDES SERVICES FOR YOUTH;ST. THOMAS THE APOSTLE- FAITH-BASED ORGANIZATION;THE CHAMBER OF MANITOWOC COUNTY- NONPROFIT SUPPORTING LOCAL BUSINESSES IN MANITOWOC COUNTY;THE CROSSING OF MANITOWOC COUNTY- NONPROFIT PROVIDING SUPPORT FOR INDIVIDUALS EXPERIENCING UNPLANNED PREGNANCIES;THE HAVEN OF MANITOWOC COUNTY, INC- NONPROFIT THAT PROVIDES SHELTER AND SUPPORTIVE SERVICES TO MEN EXPERIENCING HOMELESSNESS; ANDUNITED WAY MANITOWOC COUNTY- ENGAGES, CONVENES, AND MOBILIZES COMMUNITY RESOURCES TO ADDRESS ROOT CAUSES OF LOCAL HEALTH AND HUMAN SERVICES NEEDS. |
| PART V, SECTION B, LINE 6A | HOLY FAMILY MEMORIAL COLLABORATES WITH THE OTHER HOSPITAL SYSTEMS AND ORGANIZATIONS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A COMPREHENSIVE DATA COLLECTION PROCESS FROM A NUMBER OF KEY SOURCES. THIS SHARED CHNA SERVES AS THE FOUNDATION FOR HOLY FAMILY MEMORIAL AND IS THE BASIS FOR CREATION OF AN IMPLEMENTATION STRATEGY TO IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES IN MANITOWOC COUNTY AND THE HOSPITAL'S PRIMARY SERVICE AREA.MANITOWOC COUNTY COLLABORATIVE PARTNERS:HOLY FAMILY MEMORIAL IN AFFILIATION WITH FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN;AURORA HEALTH CARE.AFTER COMPLETION OF THE SHARED CHNA, THE DATA WAS TAKEN INTO CONSIDERATION IN ORDER FOR HOLY FAMILY MEMORIAL TO CREATE AN INDEPENDENT CHNA AND IMPLEMENTATION STRATEGY SPECIFIC TO THE HOSPITAL'S SERVICE AREA AND COMMUNITY HEALTH NEEDS. |
| PART V, SECTION B, LINE 6B | HOLY FAMILY MEMORIAL COLLABORATES WITH THE OTHER HOSPITAL SYSTEMS AND ORGANIZATIONS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A COMPREHENSIVE DATA COLLECTION PROCESS FROM A NUMBER OF KEY SOURCES. THIS SHARED CHNA SERVES AS THE FOUNDATION FOR HOLY FAMILY MEMORIAL AND IS THE BASIS FOR CREATION OF AN IMPLEMENTATION STRATEGY TO IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES IN MANITOWOC COUNTY AND THE HOSPITAL'S PRIMARY SERVICE AREA.MANITOWOC COUNTY ORGANIZATIONS:LAKESHORE CAP,LAKESHORE COMMUNITY HEALTH CENTER,UNITED WAY MANITOWOC COUNTY,MANITOWOC COUNTY HEALTH DEPARTMENT,JKV RESEARCH, ANDCENTER FOR URBAN POPULATION HEALTH.AFTER COMPLETION OF THE SHARED CHNA, THE DATA WAS TAKEN INTO CONSIDERATION IN ORDER FOR HOLY FAMILY MEMORIAL TO CREATE AN INDEPENDENT CHNA AND IMPLEMENTATION STRATEGY SPECIFIC TO THE HOSPITAL'S SERVICE AREA AND COMMUNITY HEALTH NEEDS. |
| PART V, SECTION B, LINE 7D | THE FULL VERSION OF THE MOST RECENT AND PAST CHNA SUMMARIES, REPORTS AND OTHER SUPPORTING DOCUMENTS CAN BE FOUND ON HOLY FAMILY MEMORIAL WEBSITE: HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. |
| PART V, LINE 10A | HOLY FAMILY MEMORIAL'S IMPLEMENTATION STRATEGY IS POSTED ON OUR INTRANET SITE FOR STAFF, PHYSICIANS AND LEADERS AS WELL AS THE GENERAL PUBLIC THROUGH OUR EXTERNAL WEBSITE FROEDTERT.COM. TO ACCESS THE IMPLEMENTATION STRATEGY, PLEASE GO TO: HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. |
| PART V, LINE 11 | COMMUNITY HEALTH IMPROVEMENT PLAN FOR HOLY FAMILY MEMORIAL IS AVAILABLE ONLINE AT: HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. FOR THE TAX YEAR ENDED JUNE 30, 2022, THIS INCLUDES THE TIME PERIOD REPORTED IN THIS FORM 990, HOLY FAMILY MEMORIAL ADDRESSED THE SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN ITS 2019 CHNA AND IN WHICH THE IMPLEMENTATION STRATEGY WAS ADOPTED FOR FISCAL YEARS 2020, 2021 AND 2022. THE 2022 CHNA WILL BE EFFECTIVE FOR FISCAL YEARS 2023, 2024 AND 2025 AND THE STRATEGY WAS IMPLEMENTED 11/30/2022.THE FISCAL YEAR 2020 - 2022 IMPLEMENTATION STRATEGY/COMMUNITY HEALTH IMPROVEMENT PLAN WAS REVIEWED AND ADOPTED BY THE HOLY FAMILY MEMORIAL BOARD OF DIRECTORS ON 12/4/2019.TO IDENTIFY THE STRATEGIES, HOLY FAMILY MEMORIAL STAFF REVIEWED THE COMMUNITY NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AND SELECTED THREE WHERE HOLY FAMILY MEMORIAL COULD MAKE THE MOST IMPACT AND WHICH THE ORGANIZATION HAD THE ABILITY TO EXECUTE. THE SELECTION WAS REVIEWED AND APPROVED BY HOLY FAMILY MEMORIAL EXECUTIVE LEADERSHIP, HOLY FAMILY MEMORIAL'S COMMUNITY ENGAGEMENT COMMITTEE, AND FINALLY THE HOLY FAMILY MEMORIAL BOARD OF DIRECTORS.THESE THREE OVERARCHING THEMES WERE IDENTIFIED AS PRIORITIES FOR HOLY FAMILY MEMORIAL'S FISCAL YEARS 2020 - 2022:-ALCOHOL USE OR ABUSE;-PRESCRIPTION OR OVER-THE-COUNTER DRUG ABUSE; AND-OVERWEIGHT OR OBESITY.SIGNIFICANT HEALTH NEEDS NOT ADDRESSED:BEHAVIORAL HEALTH: THIS IS INTEGRAL IN EVERY ASPECT OF HEALTH CARE AND HFM ADDRESSES IT THROUGHOUT THE SPECTRUM AS DO OTHER COMMUNITY ORGANIZATIONS;ADVERSE CHILDHOOD EXPERIENCES: THIS IS ADDRESSED BY HEALTHIEST MANITOWOC COUNTY, HUMAN SERVICES, AND THE COUNTY HEALTH DEPARTMENT;ACCESS TO HEALTH CARE: THIS IS ADDRESSED BY HEALTHIEST MANITOWOC COUNTY (HFM HAS STAFF ON THE COMMITTEE) LAKESHORE COMMUNITY HEALTH, AND PUBLIC HEALTH;CHRONIC DISEASE: HEALTHIEST MANITOWOC COUNTY (HFM HAS STAFF ON COMMITTEES), LAKESHORE COMMUNITY HEALTH CARE, AND THE HEALTH DEPARTMENT ARE LEADING THIS INITIATIVE;INJURY AND VIOLENCE: LEADERS IN THIS EFFORT ARE LOCAL COUNSELORS, MANITOWOC HEALTH DEPARTMENT, INCOURAGE, LAW ENFORCEMENT AND LOCAL GOVERNMENTS LEAD THE EFFORT. HFM SANE PROGRAM DOES PARTICIPATE;ORAL HEALTH: THIS IS LED PRIMARILY THROUGH DENTAL SERVICES AND LAKESHORE COMMUNITY HEALTH;ENVIRONMENTAL AND OCCUPATIONAL HEALTH: THE UW EXTENSION, FARM WISCONSIN DISCOVERY CENTER, FARM BUREAU, AND TECH COLLEGES FIGURE PROMINENTLY IN THIS EFFORT;COMMUNICABLE DISEASE: CHURCHES AND SCHOOLS ARE KEY PARTNERS WITH HEALTHIEST MANITOWOC COUNTY;HEALTHY GROWTH AND DEVELOPMENT: SCHOOLS, RETIREMENT COMMUNITIES, ADRC AND SENIOR CENTERS WORK WITH HEALTHIEST MANITOWOC COUNTY;REPRODUCTIVE AND SEXUAL HEALTH: PLANNED PARENTHOOD, LAKESHORE COMMUNITY HEALTH AND SOCIAL SERVICE AGENCIES ARE KEY PARTICIPANTS; ANDTOBACCO USE AND EXPOSURE: POLICE, PARENTS AND SCHOOLS WORK WITH HEALTHIEST MANITOWOC COUNTY ON THIS.HOLY FAMILY MEMORIAL SUMMARY OF IMPLEMENTATION STRATEGY:HOLY FAMILY MEMORIAL HAS COMPLETED AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE HOSPITAL'S IMPLEMENTATION STRATEGY TO MEET THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THIS CHNA. THE FOLLOWING IS A SUMMARY OF THAT SEPARATE, MORE COMPREHENSIVE IMPLEMENTATION STRATEGY REPORT.THE KEY PROGRAMS, STRATEGIES AND DEDICATED HOSPITAL RESOURCES INTENDED TO ADDRESS IDENTIFIED SIGNIFICANT COMMUNITY HEALTH NEEDS ARE ADDRESSED BELOW. COMMUNITY ENGAGEMENT AND HOLY FAMILY MEMORIAL HAVE DEDICATED EMPLOYEES AND BUDGETED FUNDS TOWARD SERVING THE NEEDS OF THE HOLY FAMILY MEMORIAL COMMUNITIES. TO ACCESS A COPY OF THE FULL IMPLEMENTATION STRATEGY, PLEASE GO TO HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/.TREATMENT, COMMUNITY COALITIONS AND EDUCATIONCHNA SIGNIFICANT HEALTH NEED: ALCOHOL USE OR ABUSEGOAL: IMPROVE SUBSTANCE ABUSE AND CARE SERVICES FOR OUR COMMUNITY.HOLY FAMILY MEMORIAL AVAILABLE RESOURCES:-PARTNER WITH CORE TREATMENT SERVICES TO OPEN RESIDENTIAL AODA TREATMENT BEDS AND ADDITIONAL OUTPATIENT SERVICES IN A FACILITY ON HOLY FAMILY MEMORIAL'S CAMPUS IN 2020;-PARTICIPATE IN HEALTHIEST MANITOWOC COUNTY AODA INITIATIVES TO ASSIST WITH COMMUNITY-WIDE EDUCATION AND OUTREACH;-PROVIDE AODA EDUCATION TO AREA VETERANS THROUGH OUTREACH/COMMUNITY EDUCATION INITIATIVESHOLY FAMILY MEMORIAL COLLABORATIVE PARTNERS:-CORE TREATMENT SERVICES,-HEALTHIEST MANITOWOC COUNTY, AND-VETERANS SERVICES.CORE TREATMENT SERVICES:FY 2020 OUTCOMES/PROGRESS:-CORE TREATMENT SERVICES OPENED IN MARCH 2020FY 2021 OUTCOMES/PROGRESS:-CORE TREATMENT SERVICES IN MARCH 2020;-IN FY21, CORE TREATMENT SERVICES ADDED TWO CRISIS BEDSFY 2022 OUTCOMES/PROGRESS:-NO OTHER SUPPORT WAS PROVIDED AFTER CORE OPENED IN MARCH 2020.HEALTHIEST MANITOWOC COUNTY:FY 2020 OUTCOMES/PROGRESS:-DID NOT HAPPEN IN FY20 DUE TO COVID-19FY 2021 OUTCOMES/PROGRESS:-DID NOT HAPPEN IN FY21 DUE TO COVID-19FY 2022 OUTCOMES/PROGRESS:-DID NOT HAPPEN IN FY22 DUE TO COVID-19.VETERANS SERVICES:FY 2020 OUTCOMES/PROGRESS:-PROVIDED MONTHLY COFFEE EVENTS FOR 2-3 VETERANSFY 2021 OUTCOMES/PROGRESS:-HOLY FAMILY MEMORIAL DID NOT PROVIDE EDUCATION AND OUTREACH DUE TO COVID-19 BUT CORE TREATMENT SERVICES ADDRESSED A PORTION OF NEEDS DUE TO THE HIGH NUMBER OF VETERANS SEEKING AODA SERVICESFY 2022 OUTCOMES/PROGRESS:-HOLY FAMILY MEMORIAL DID NOT PROVIDE EDUCATION AND OUTREACH DUE TO COVID-19 BUT CORE TREATMENT SERVICES ADDRESSED A PORTION OF NEEDS DUE TO THE HIGH NUMBER OF VETERANS SEEKING AODA SERVICES.EDUCATION, TRACKING, COMMUNITY COALITIONS AND TREATMENTCHNA SIGNIFICANT HEALTH NEED: PRESCRIPTION OR OVER-THE-COUNTER DRUG ABUSEGOAL: REDUCE PRESCRIPTION AND OVER-THE-COUNTER DRUG ABUSE IN MANITOWOC COUNTY.HOLY FAMILY MEMORIAL AVAILABLE RESOURCES:-PROVIDE PROVIDER EDUCATION ON OPIOID AND OTHER DRUG ABUSE;-IMPLEMENT EMR OPIOID TRACKING;-PARTICIPATE IN HEALTHIEST MANITOWOC COUNTY AODA COMMITTEES AND INITIATIVES;-PROVIDERS OFFER MEDICATION-ASSISTED-TREATMENT IN COLLABORATION WITH HOLY FAMILY MEMORIAL BEHAVIORAL HEALTHHOLY FAMILY MEMORIAL COLLABORATIVE PARTNERS:-HEALTHIEST MANITOWOC COUNTY,-AURORA HEALTHCARE, AND-LOCAL PHARMACIES. PROVIDER EDUCATION:FY 2020 OUTCOMES/PROGRESS:-THERE IS CONTINUED EDUCATION AROUND PRESCRIPTION OR OVER-THE-COUNTER DRUG ABUSE AT PROVIDER OPERATIONS COUNCIL MEETINGSFY 2021 OUTCOMES/PROGRESS:-THERE IS CONTINUED EDUCATION AROUND PRESCRIPTION OR OVER-THE-COUNTER DRUG ABUSE AT PROVIDER OPERATIONS COUNCIL MEETINGSFY 2022 OUTCOMES/PROGRESS:-THERE IS CONTINUED EDUCATION AROUND PRESCRIPTION OR OVER-THE-COUNTER DRUG ABUSE AT PROVIDER OPERATIONS COUNCIL MEETINGS. |
| PART V, LINE 11 (CONT) | EMR TRACKING:FY 2020 OUTCOMES/PROGRESS:-EMR TRACKING WAS ROLLED IN LATE 2020 WITH PROVIDER EDUCATION HAPPENING IN FY21;FY 2021 OUTCOMES/PROGRESS:-NO FURTHER SUPPORT WAS PROVIDED;FY 2022 OUTCOMES/PROGRESS:-NO FURTHER SUPPORT WAS PROVIDED.HEALTHIEST MANITOWOC COUNTY:FY 2020 OUTCOMES/PROGRESS:-DID NOT HAPPEN IN FY20 DUE TO COVID-19;FY 2021 OUTCOMES/PROGRESS:-DID NOT HAPPEN IN FY21 DUE TO COVID-19;FY 2022 OUTCOMES/PROGRESS:-DID NOT HAPPEN IN FY22 DUE TO COVID-19.MAT COLLABORATION:FY 2020 OUTCOMES/PROGRESS:-THERE ARE TWO PROVIDERS WHO OFFER MAT SERVICES;-100 PATIENTS WERE PRESCRIBED MEDICATIONS IN FY20;FY 2021 OUTCOMES/PROGRESS:-THERE ARE TWO PROVIDERS WHO OFFER MAT SERVICES;-144 PATIENTS WERE PRESCRIBED MEDICATIONS IN FY21;FY 2022 OUTCOMES/PROGRESS:-THERE ARE TWO PROVIDERS WHO OFFER MAT SERVICES;-92 PATIENTS WERE PRESCRIBED MEDICATIONS IN FY22.EDUCATION AND OUTREACHCHNA SIGNIFICANT HEALTH NEED: OVERWEIGHT OR OBESITYGOAL: MODEL AND INSPIRE HEALTHY NUTRITION AND EXERCISE TO ADDRESS OVERWEIGHT AND OBESITY.HOLY FAMILY MEMORIAL AVAILABLE RESOURCES:-ENHANCE EXISTING HOLY FAMILY MEMORIAL LEAN ON THE LAKESHORE EVENT TO KEEP FOCUS ON WEIGHT LOSS;-EXPAND MOVE MANITOWOC EFFORTS TO INCLUDE MORE BUSINESSES AND SHARE THE HEALTH BENEFITS OF BEING ACTIVE;-INCREASE UTILIZATION OF PRESCRIPTIONS FOR SERVICES THROUGH THE WELLNESS CENTERHOLY FAMILY MEMORIAL COLLABORATIVE PARTNERS:-AURORA HEALTHCARE,-LIGHTHOUSE RECOVERY,-FESTIVAL FOODS, AND-MANITOWOC PUBLIC WORKS DEPARTMENT.LEAN ON THE LAKESHORE:FY 2020 OUTCOMES/PROGRESS:-EVENT WAS CANCELLED DUE TO COVID-19 ISSUES;FY 2021 OUTCOMES/PROGRESS:-EVENT WAS CANCELLED PERMANENTLY DUE TO LACK OF INTEREST;FY 2022 OUTCOMES/PROGRESS:-EVENT WAS CANCELLED PERMANENTLY DUE TO LACK OF INTEREST.MOVE MANITOWOC:FY 2020 OUTCOMES/PROGRESS:-EFFORT HAS BEEN CANCELLED PERMANENTLY DUE TO COVID-19 ISSUES;FY 2021 OUTCOMES/PROGRESS:-EFFORT HAS BEEN CANCELLED PERMANENTLY DUE TO COVID-19 ISSUES;FY 2022 OUTCOMES/PROGRESS:-EFFORT HAS BEEN CANCELLED PERMANENTLY DUE TO COVID-19 ISSUES.PRESCRIPTIONS FOR WELLNESS CENTER SERVICES:FY 2020 OUTCOMES/PROGRESS:-58 INDIVIDUALS RECEIVED A PRESCRIPTION OR A FREE VOUCHER FOR WELLNESS CENTER SERVICES;FY 2021 OUTCOMES/PROGRESS:-95 INDIVIDUALS RECEIVED A PRESCRIPTION OR A FREE VOUCHER FOR WELLNESS CENTER SERVICES;FY 2022 OUTCOMES/PROGRESS:-51 INDIVIDUALS RECEIVED A PRESCRIPTION OR A FREE VOUCHER FOR WELLNESS CENTER SERVICES.OTHER ENGAGEMENT PROGRAMS AND INITIATIVESCOMMUNITY ENGAGEMENT PROACTIVELY ADDRESSES THE SOCIAL, CULTURAL AND ECONOMIC DETERMINANTS THAT UNDERPIN HEALTH AND SEEKS TO BUILD PARTNERSHIPS WITH OTHERS TO FIND SOLUTIONS. FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN ARE COMMITTED TO MAKING A POSITIVE, SUSTAINED DIFFERENCE IN OUR COMMUNITY. COMMUNITY ENGAGEMENT WILL STRENGTHEN THE ECONOMIC VITALITY AND QUALITY OF LIFE OF THOSE COMMUNITIES WE SERVE. HOLY FAMILY MEMORIAL COMMUNITY ENGAGEMENT PROGRAMMING AND HEALTH IMPROVEMENT ACTIVITIES ARE SUPPORTED THROUGH STAFF RESOURCES, BUDGETED DOLLARS FOR PROGRAMMING AND COMMUNITY PARTNERSHIPS. SEXUAL ASSAULT NURSE EXAMINER (SANE) AVAILABLE 24 HOURS A DAY (ACCESS TO CARE AND NAVIGATION)WHEN EMERGENCIES TAKE ON THE EVEN MORE TRAUMATIC ELEMENT OF SEXUAL ASSAULT, THE SPECIALLY TRAINED SANE PROGRAM STAFF HAS CREATED A SAFE HAVEN AT HOLY FAMILY MEMORIAL FOR COMPREHENSIVE, COMPASSIONATE CARE. SANE STAFF ARE REGISTERED NURSES WITH ADVANCED TRAINING IN MEDICAL-FORENSIC EXAMINATION AND IN THE PSYCHOLOGICAL AND EMOTIONAL TRAUMA PATIENT'S EXPERIENCE. THEY CARE FOR VICTIMS OF ALL AGES, RACES, AND POPULATIONS TO PROVIDE TIMELY EMOTIONAL SUPPORT. SANE NURSES ARE AVAILABLE TO SPEAK TO GROUPS AND ORGANIZATIONS. THEY ARE ALSO ABLE TO SERVE AS EXPERT WITNESSES IF CALLED TO TESTIFY AT A TRIAL. SERVICES PROVIDED:-PHYSICAL EXAMINATION AND WELLNESS CHECK,-COLLECTION OF MEDICAL-FORENSIC EVIDENCE,-ASSISTANCE WITH REPORTING THE CRIME TO POLICE, WHEN REQUESTED (MANDATORY REPORTING FOR CHILDREN),-ASSISTANCE WITH CONCERNS ABOUT SEXUALLY TRANSMITTED INFECTION AND PREGNANCY,-ASSISTANCE WITH SAFETY PLANNING, AND-DEVELOPMENT OF A MEDICAL FOLLOW-UP PLAN. LEADERSHIP VOLUNTEERISM/COMMUNITY SUPPORT (FROEDTERT IN ACTION) (COMMUNITY BUILDING)HOLY FAMILY MEMORIAL ENCOURAGES ITS LEADERS TO PARTICIPATE IN COMMUNITY ACTIVITIES SUPPORTING LOCAL NONPROFIT ORGANIZATIONS. LEADERS ARE ACTIVE WITH GROUPS SUCH AS AREA VOLUNTEER FIRE DEPARTMENTS AND FIRST RESPONDER GROUPS, HEALTHIEST MANITOWOC COUNTY, LOCAL CHURCHES, THE CHAMBER OF MANITOWOC COUNTY, PROGRESS LAKESHORE, BIG BROTHERS BIG SISTERS, BOYS AND GIRLS CLUB, THE HAVEN HOMELESS SHELTER, VARIOUS FOOD PANTRIES AND MORE. ALL OF THESE ACTIVITIES ARE VOLUNTEER.FOR MORE INFORMATION ON HOLY FAMILY MEMORIAL COMMUNITY BENEFIT PROGRAMS, PLEASE VISIT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. |
| PART V, SECTION B, LINE 13B | IN ALIGNMENT WITH THE FH FINANCIAL ASSISTANCE POLICY, HFM RESERVES THE RIGHT TO REVIEW EACH APPLICATION FOR FINANCIAL ASSISTANCE ON ITS OWN MERITS AND TO CONSIDER OTHER EXTENUATING CIRCUMSTANCES IN THE DECISION TO APPROVE OR DENY A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. THE APPLICANT'S GROSS FAMILY INCOME WILL BE DETERMINED USING MODIFIED ADJUSTED GROSS INCOME (MAGI). MODIFIED ADJUSTED GROSS INCOME INCLUDES BOTH EARNED INCOME AND PASSIVE INCOME RECEIVED AND COMPARED TO THE ANNUAL FEDERAL POVERTY GUIDELINES SET FORTH BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. A PATIENT WHO HAS AN ANNUAL GROSS INCOME EQUAL TO OR LESS THAN 400% OF THE CURRENT YEAR'S POVERTY GUIDELINES WILL NOT PAY MORE THAN 15% OF THEIR ANNUAL GROSS INCOME ON ANY SINGLE ACCOUNT DURING THE APPROVED ELIGIBILITY TIMEFRAME. PATIENTS WHO MEET THE REQUIREMENTS AND HAVE A GROSS INCOME EQUAL OR LESS THAN 250% OF THE FPL MAY QUALIFY FOR A 100% DISCOUNT. PATIENTS WHO MEET THE REQUIREMENTS AND HAVE A GROSS INCOME BETWEEN 250% AND 400% OF THE FPL MAY QUALIFY FOR A DISCOUNT ON A SLIDING SCALE. IN ADDITION TO INCOME, HFM ALSO TAKES CERTAIN ASSETS INTO CONSIDERATION. ASSETS PROTECTED FROM FINANCIAL EVALUATION INCLUDE A HOUSEHOLD'S RETIREMENT ASSETS, HOME EQUITY, AND A PORTION OF CASH AND SAVINGS ASSETS. |
| PART V, SECTION B, LINE 13H | OUT OF POCKET MAXIMUM DISCOUNT. |
| PART V, LINE 16B, FAP APPLICATION WEBSITE | WWW.FROEDTERT.COM/FINANCIAL-SERVICES |
| PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE | WWW.HFMHEALTH.ORG/WP-CONTENT/UPLOADS/ |
| PART V, SECTION B, LINE 20E | WE REQUEST ADDITIONAL DOCUMENTATION WHEN AN INDIVIDUAL HAS SUBMITTED AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - FROEDTERT MANITOWOC MEDICAL GROUP | ||||
| 1650 S 41ST ST | MANITOWOC | WI | 54220 | PHYSICIAN MEDICAL GROUP |
| 2 - HOLY FAMILY HEALTH SERVICES INC | ||||
| 1650 S 41ST ST | MANITOWOC | WI | 54220 | RETAIL PHARMACY |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C | IN ALIGNMENT WITH THE FROEDTERT HEALTH, INC. FINANCIAL ASSISTANCE POLICY HFM RESERVES THE RIGHT TO REVIEW EACH APPLICATION FOR FINANCIAL ASSISTANCE ON ITS OWN MERITS AND TO CONSIDER OTHER EXTENUATING CIRCUMSTANCES IN THE DECISION TO APPROVE OR DENY A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. THE APPLICANT'S GROSS FAMILY INCOME WILL BE COMPARED TO THE ANNUAL FEDERAL POVERTY GUIDELINES SET FORTH BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. A PATIENT WHO HAS AN ANNUAL GROSS INCOME EQUAL TO OR LESS THAN 400% OF THE CURRENT YEAR'S POVERTY GUIDELINES WILL NOT PAY MORE THAN 15% OF THEIR ANNUAL GROSS INCOME ON ANY SINGLE ACCOUNT DURING THE APPROVED ELIGIBILITY TIMEFRAME. PATIENTS WHO MEET THE REQUIREMENTS AND HAVE A GROSS INCOME EQUAL OR LESS THAN 250% OF THE FPG MAY QUALIFY FOR A 100% DISCOUNT. PATIENTS WHO MEET THE REQUIREMENTS AND HAVE A GROSS INCOME BETWEEN 250% AND 400% OF THE FPG MAY QUALIFY FOR A DISCOUNT ON A SLIDING SCALE. IN ADDITION TO INCOME, HFM ALSO TAKES CERTAIN ASSETS INTO CONSIDERATION. ASSETS PROTECTED FROM FINANCIAL EVALUATION INCLUDE A PORTION OF A HOUSEHOLD'S RETIREMENT ASSETS, CASH, SAVINGS ASSETS AND HOME EQUITY. |
| PART I, LINE 6A | EVERY YEAR, HOLY FAMILY MEMORIAL PRODUCES AN ANNUAL REPORT TO THE COMMUNITY HIGHLIGHTING ALL OF THE HOSPITALS AND CLINICS EFFORTS IN COMMUNITY OUTREACH PROGRAMS, PATIENT IMPACT STORIES AND INVESTMENTS IN THE COMMUNITIES WE SERVE. THE REPORT IS POSTED ON THE HOLY FAMILY MEMORIAL WEBSITE AND SOCIAL MEDIA PLATFORMS, HOLY FAMILY MEMORIAL BOARD OF DIRECTORS, HOLY FAMILY MEMORIAL LEADERS AND STAFF, GOVERNMENT OFFICIALS, BUSINESS LEADERS AND OTHER COMMUNITY MEMBERS. A COPY OF THE MOST RECENT REPORT CAN BE FOUND AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. |
| PART I, LINE 7 | COMMUNITY BENEFITS ARE PROGRAMS OR ACTIVITIES THAT PROVIDE CARE AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. HFM'S COMMUNITY BENEFIT PROGRAMS INCLUDE SERVICES FOR THOSE WHO CANNOT AFFORD HEALTH CARE AND INITIATIVES FOR IMPROVING HEALTH IN THE BROADER COMMUNITY. PROVIDING COMMUNITY BENEFITS DEMONSTRATES THAT HOLY FAMILY MEMORIAL IS FULFILLING ITS CHARITABLE MISSION AND DEMONSTRATES THAT ITS PREFERENTIAL TAX STATUS IS DESERVED. |
| PART I, LINE 7, COLUMN (F) | THE PERCENTAGE OF COMMUNITY BENEFIT EXPENSE TO OVERALL EXPENSES REPORTED ON FORM 990 FOR HFM. |
| PART II | TO PROMOTE THE HEALTH OF OUR COMMUNITIES, HOLY FAMILY MEMORIAL PARTICIPATES IN NUMEROUS COMMUNITY-BUILDING ACTIVITIES, WHICH ARE NOT INCLUDED ELSEWHERE ON SCHEDULE H. THESE ACTIVITIES INCLUDE:1. COALITION BUILDING: COLLABORATION WITH COUNTY SERVICE AGENCIES INCLUDES WORK WITH THE MANITOWOC COUNTY COMMUNITY COALITION TO ADDRESS SUBSTANCE USE AND ABUSE, OBESITY AND MENTAL HEALTH ISSUES. HOLY FAMILY MEMORIAL'S SANE (SEXUAL ASSAULT NURSE EXAMINER PROGRAM) WORKS CLOSELY WITH VOLUNTEERS FROM THE INCOURAGE TO CARE FOR VICTIMS OF SEXUAL ASSAULT.2. COMMUNITY SUPPORT: PARTICIPATION IN LOCAL EMERGENCY PREPAREDNESS AND YOUTH FOCUSED COALITIONS TO IMPROVE THE COMMUNITIES' ABILITY TO RESPOND TO AN EMERGENCY AND TO IMPROVE THE COMMUNITY ENVIRONMENT FOR YOUTH TO SET THEM UP FOR GREATER SUCCESS.3. ECONOMIC DEVELOPMENT: LEADERSHIP PARTICIPATES IN LOCAL CHAMBER OF COMMERCE BOARDS FOCUSING ON ECONOMIC DEVELOPMENT.4. DIVERSITY: TRAINING THAT RECRUITS HEALTH PROFESSIONALS IN OUR TRADITIONALLY UNDERSERVED COMMUNITY.5. WORKFORCE DEVELOPMENT: DIVERSITY TRAINING AND MINORITY INTERNSHIP PROGRAMS THAT RECRUIT HEALTH PROFESSIONALS IN OUR TRADITIONALLY UNDERSERVED COMMUNITIES TO DIVERSIFY OUR WORKFORCE POPULATION TO BETTER SERVE OUR COMMUNITIES. |
| PART III, LINE 2 | THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS AND TRENDS. THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. |
| PART III, LINE 3 | THE FINANCIAL ASSISTANCE POLICY ALLOWS FOR ACCOUNTS IN BAD DEBT TO BE APPROVED FOR FINANCIAL ASSISTANCE IF THE PATIENT MEETS THE CRITERIA. THERE ARE POSSIBLE FINANCIAL ASSISTANCE ACCOUNTS IN BAD DEBT, ALTHOUGH THE EXACT PERCENTAGE IS UNKNOWN AS WE DO NOT HAVE THE APPROPRIATE TOOLS TO DETERMINE THIS PERCENTAGE ACCURATELY. |
| PART III, LINE 4 | PATIENTS' ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLE, FROEDTERT HEALTH, INC. (FH) ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE 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. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE, FH ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS 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 AS WELL AS PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD PARTY COVERAGE EXISTS FOR PART OF THE BILL), FROEDTERT HEALTH, INC. 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. FH RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, FROEDTERT HEALTH, INC. RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF FH'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, FH RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED.SEE ALSO PAGE 29-31 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8 | HFM BELIEVES THAT ALL OF THE SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THE HOSPITAL PROVIDES EMERGENCY MEDICAL CARE OR OTHER MEDICALLY NECESSARY CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES.THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS IS BASED ON A CALCULATION DEVELOPED BY THE AMERICAN HOSPITAL ASSOCIATION IN WHICH THE DATA IS DERIVED FROM THE ANNUAL FILED MEDICARE COST REPORT. |
| PART III, LINE 9B | IN ALIGNMENT WITH THE FH FINANCIAL ASSISTANCE POLICY AND CREDIT AND COLLECTIONS POLICY REGARDING THE BILLING, COLLECTION, AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS, HFM MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICIES FOR ASSISTING THOSE PATIENTS WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE IN A PROFESSIONAL AND CONSISTENT MANNER. STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS SUCH AS PATIENT FINANCIAL SERVICES CUSTOMER SERVICE AND FINANCIAL COUNSELING STAFF, AS WELL AS THOSE INVOLVED IN BILLING AND COLLECTIONS, ARE TRAINED ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE OR THEIR ABILITY TO PAY FOR SERVICES. OTHER STAFF WHO MAY HAVE INTERACTIONS WITH PATIENTS, SUCH AS ADMITTING STAFF, ARE ALSO AWARE OF THE POLICY AND ARE ABLE TO PROVIDE PATIENTS A COPY OF AN APPLICATION UPON REQUEST AND ALSO ARE COMMITTED TO TREATING PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE OR THEIR ABILITY TO PAY FOR SERVICES. |
| PART VI, LINE 2 | IN 2019, A CHNA WAS CONDUCTED TO 1) DETERMINE CURRENT COMMUNITY HEALTH NEEDS IN MANITOWOC COUNTY, 2) GATHER INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY AND IDENTIFY COMMUNITY ASSETS, 3) IDENTIFY AND PRIORITIZE SIGNIFICANT HEALTH NEEDS, AND 4) DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS THE PRIORITIZED HEALTH NEEDS. HOLY FAMILY MEMORIAL ASSESSED THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A COMPREHENSIVE DATA COLLECTION PROCESS FROM A NUMBER OF KEY SOURCES. DATA AND RESEARCH INCLUDED INFORMATION FROM COMMUNITY MEMBERS, PUBLIC HEALTH OFFICIALS, COMMUNITY LEADERS/EXPERTS, AND NON-PROFIT ORGANIZATIONS REPRESENTING VULNERABLE POPULATIONS IN OUR SERVICE AREA. THE FOLLOWING INFORMATION/DATA SOURCES WAS COLLECTED AND TAKEN INTO CONSIDERATION FOR ASSESSING AND ADDRESSING COMMUNITY HEALTH NEEDS:COMMUNITY HEALTH SURVEY: USING THE CENTER FOR DISEASE CONTROL'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), A TELEPHONE-BASED SURVEY OF 400 RESIDENTS WAS CONDUCTED BY HOLY FAMILY MEMORIAL IN COLLABORATION WITH AURORA HEALTH CARE, LAKESHORE CAP, LAKESHORE COMMUNITY HEALTH CENTER, UNITED WAY MANITOWOC COUNTY AND THE MANITOWOC COUNTY HEALTH DEPARTMENT. THE FULL REPORT OF THIS SURVEY CAN BE FOUND AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. KEY INFORMANT INTERVIEWS: HOLY FAMILY MEMORIAL LEADERS CONDUCTED 31 IN-PERSON INTERVIEWS WITH 32 COMMUNITY LEADERS OF VARIOUS SCHOOL DISTRICTS, NON-PROFIT ORGANIZATIONS, HEALTH & HUMAN SERVICE DEPARTMENT AND BUSINESS LEADERS. THE FULL KEY INFORMANT RESULTS CAN BE FOUND AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. COMMUNITY PARTNER/AGENCY REPORTS: TO BETTER UNDERSTAND THE NEEDS OF OUR UNDERSERVED POPULATIONS; HOLY FAMILY MEMORIAL OBTAINED IMPORTANT DATA AND TRENDS FROM PARTNER ORGANIZATIONS SUCH AS LAKESHORE COMMUNITY HEALTH CENTER, UNITED WAY MANITOWOC COUNTY ALICE REPORT AND OTHERS TO SEEK IMPORTANT TRENDS, DEMOGRAPHIC DATA AND SERVICES TO PROVIDE AN INCLUSIVE VIEWPOINT OF COMMUNITY NEEDS FOR THESE UNREPRESENTED POPULATIONS.SECONDARY DATA REPORTS: UTILIZING MULTIPLE COUNTY AND COMMUNITY-BASED PUBLICLY AVAILABLE REPORTS, INFORMATION WAS GATHERED REGARDING: MORTALITY/MORBIDITY DATA, INJURY HOSPITALIZATIONS, EMERGENCY DEPARTMENT VISITS, MANITOWOC COUNTY HEALTH RANKINGS, PUBLIC SAFETY/CRIME REPORTS AND SOCIO-ECONOMIC DATA. A FULL SUMMARY OF SECONDARY DATA INFORMATION CAN BE FOUND AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. HOLY FAMILY MEMORIAL IS COMMITTED TO ADDRESSING COMMUNITY HEALTH NEEDS COLLABORATIVELY WITH LOCAL PARTNERS. HOLY FAMILY MEMORIAL USED THE FOLLOWING METHODS TO GAIN COMMUNITY INPUT FROM FEBRUARY-MARCH 2019 ON THE SIGNIFICANT HEALTH NEEDS OF THE HOLY FAMILY MEMORIAL'S COMMUNITY. THESE METHODS PROVIDED ADDITIONAL PERSPECTIVES ON HOW TO SELECT AND ADDRESS TOP HEALTH ISSUES FACING HOLY FAMILY MEMORIAL'S COMMUNITY.INPUT FROM COMMUNITY MEMBERSKEY INFORMANT INTERVIEWS: KEY ORGANIZATIONS WITH SPECIFIC KNOWLEDGE AND INFORMATION RELEVANT TO THE SCOPE OF THE IDENTIFIED SIGNIFICANT HEALTH NEEDS ("INFORMANTS") IN HOLY FAMILY MEMORIAL'S COMMUNITY, INCLUDING MANITOWOC COUNTY, WERE IDENTIFIED BY ORGANIZATIONS AND PROFESSIONALS THAT REPRESENT THE BROAD NEEDS OF THE COMMUNITY AS WELL AS ORGANIZATIONS THAT SERVE LOW-INCOME AND UNDERSERVED POPULATIONS. THESE LOCAL PARTNERING ORGANIZATIONS ALSO INVITED THE INFORMANTS TO PARTICIPATE IN AND CONDUCT THE INTERVIEWS. THE INTERVIEWERS USED A STANDARD INTERVIEW SCRIPT THAT INCLUDED THE FOLLOWING ELEMENTS:RANKING OF UP TO FIVE PUBLIC HEALTH ISSUES, BASED ON THE FOCUS AREAS PRESENTED IN WISCONSIN'S STATE HEALTH PLAN, THAT ARE THE MOST IMPORTANT ISSUES FOR THE COUNTY; AND FOR THOSE FIVE PUBLIC HEALTH ISSUES: -EXISTING STRATEGIES TO ADDRESS THE ISSUE -BARRIERS AND CHALLENGES TO ADDRESSING THE ISSUE -ADDITIONAL STRATEGIES NEEDED -KEY GROUPS IN THE COMMUNITY THAT HOSPITALS SHOULD PARTNER WITH TO IMPROVE COMMUNITY HEALTH -IDENTIFICATION OF SUBGROUPS OR SUBPOPULATIONS WHERE EFFORTS COULD BE TARGETED -WAYS EFFORTS CAN BE TARGETED TOWARD EACH SUBGROUP OR SUBPOPULATION UNDERSERVED POPULATION INPUT: HOLY FAMILY MEMORIAL IS DEDICATED TO REDUCING HEALTH DISPARITIES AND INPUT FROM COMMUNITY MEMBERS WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AND/OR ORGANIZATIONS THAT REPRESENT THOSE POPULATIONS ARE IMPORTANT IN ADDRESSING COMMUNITY HEALTH NEEDS. WITH THAT IN MIND, HOLY FAMILY MEMORIAL TOOK THE FOLLOWING STEPS TO GAIN INPUT:-COMMUNITY HEALTH SURVEY: WHEN APPROPRIATE, DATA WAS STRATIFIED BY GENDER, AGE, EDUCATION HOUSEHOLD INCOME LEVEL AND MARITAL STATUS.-KEY INFORMANT INTERVIEWS: THE KEY INFORMANT INTERVIEWS INCLUDED INPUT FROM MEMBERS OF ORGANIZATIONS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS.SUMMARY OF COMMUNITY MEMBER INPUTTOP FIVE HEALTH ISSUES RANKED MOST CONSISTENTLY OR MOST OFTEN CITED FOR MANITOWOC COUNTY WERE:KEY INFORMANT INTERVIEWS:-MENTAL HEALTH-SUBSTANCE USE AND ABUSE-ALCOHOL ABUSE-ADVERSE CHILDHOOD EXPERIENCES-ACCESS TO HEALTH CARECOMMUNITY HEALTH SURVEY:-ILLEGAL DRUG USE-ALCOHOL USE OR ABUSE-PRESCRIPTION OR OTC DRUG ABUSE-ACCESS TO HEALTH CARE-CHRONIC DISEASESAFTER ADOPTION OF THE CHNA REPORT AND IMPLEMENTATION STRATEGY, HOLY FAMILY MEMORIAL PUBLICLY SHARES BOTH DOCUMENTS WITH COMMUNITY PARTNERS, KEY INFORMANTS, HOSPITAL BOARD MEMBERS, PUBLIC SCHOOLS, NON-PROFITS, HOSPITAL COALITION MEMBERS, THE MANITOWOC COUNTY HEALTH DEPARTMENT, AND THE GENERAL PUBLIC. DOCUMENTS ARE MADE AVAILABLE VIA EMAIL, HARD COPIES ARE MADE AVAILABLE AT APPLICABLE MEETINGS, AND ELECTRONIC COPIES ARE MADE AVAILABLE BY PDF FOR DOWNLOAD ON HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/.FEEDBACK AND PUBLIC COMMENTS ARE ALWAYS WELCOMED AND ENCOURAGED, AND CAN BE PROVIDED THROUGH THE CONTACT FORM ON THE FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN WEBSITE AT HTTPS://WWW.FROEDTERT.COM/CONTACT, OR CONTACTING FROEDTERT HEALTH, INC.'S COMMUNITY ENGAGEMENT LEADERSHIP/STAFF WITH QUESTIONS AND CONCERNS BY CALLING 414-777-1926. HOLY FAMILY MEMORIAL RECEIVED NO COMMENTS OR ISSUES WITH THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND/IMPLEMENTATION STRATEGY. |
| PART VI, LINE 3 | INFORMATION ON ELIGIBILITY FOR ASSISTANCE IS AVAILABLE FROM HFM'S WEBSITE, BROCHURES, ADMISSIONS STAFF, COLLECTION CORRESPONDENTS, AS WELL AS INSURANCE BENEFIT PAPERWORK THAT IS SENT TO PATIENTS FOR INPATIENT, SAME DAY SURGERY, MRI, AND CT SCANS. A PATIENT FINANCIAL ADVISOR AND/OR ELIGIBILITY SPECIALIST COMMUNICATES TO SELF PAY INPATIENTS TO INTERVIEW AND ADVISE PATIENTS OF ANY PROGRAMS THEY MAY QUALIFY FOR, INCLUDING, BUT NOT LIMITED TO, MEDICAID, VETERANS ADMINISTRATION, OR OUR OWN CHARITY PROGRAM. IF THEY QUALIFY FOR MEDICAID OR VETERANS ADMINISTRATION, WE ASSIST THEM IN COMPLETING THE APPLICATION AND FOLLOW UP ON THE APPLICATION THROUGH APPROVAL. FOR THE NETWORK CHARITY PROGRAM, AN APPLICATION IS PROVIDED AND THE PATIENT IS INSTRUCTED ON WHOM TO CONTACT FOR ASSISTANCE FOR APPLYING. WHEN CONTACTING PATIENTS BY PHONE, THE PATIENT FINANCIAL ADVISOR OR ELIGIBILITY SPECIALIST IS TRAINED TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR OUTSIDE STATE OR FEDERAL ASSISTANCE AND WILL ASSIST THOSE PATIENTS TO APPLY FOR THOSE PROGRAMS. |
| PART VI, LINE 4 | OVERVIEWHOLY FAMILY MEMORIAL, IN AFFILIATION WITH THE FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN HEALTH NETWORK, IS THE RECOGNIZED LEADER AND LARGEST PROVIDER OF COMPREHENSIVE HEALTH CARE SERVICES IN MANITOWOC COUNTY. FOUNDED BY THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY, HOLY FAMILY MEMORIAL, ROOTED IN THE HEALING MINISTRY OF JESUS CHRIST, IS COMMITTED TO PROVIDING HIGH QUALITY MEDICAL CARE AND DEDICATED TO HELPING INDIVIDUALS IN THE COMMUNITIES HOLY FAMILY MEMORIAL SERVES ACHIEVE HEALTHIER LIVES. THE FROEDTERT & MCW HEALTH NETWORK OPERATES EASTERN WISCONSIN'S ONLY ACADEMIC MEDICAL CENTER AND ADULT LEVEL I TRAUMA CENTER AT FROEDTERT HOSPITAL, MILWAUKEE. IT ALSO INCLUDES EIGHT HOSPITAL LOCATIONS, NEARLY 2,000 PHYSICIANS AND MORE THAN 45 HEALTH CENTERS AND CLINICS.MISSION STATEMENTFROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN ADVANCE THE HEALTH OF THE PEOPLE OF THE DIVERSE COMMUNITIES WE SERVE THROUGH EXCEPTIONAL CARE ENHANCED BY INNOVATION AND DISCOVERY.SERVICE AREA AND DEMOGRAPHICSFOR THE PURPOSE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE COMMUNITY IS DEFINED AS MANITOWOC COUNTY, BECAUSE 86.7% OF DISCHARGES OCCUR FROM THIS GEOGRAPHY. ALL PROGRAMS, ACTIVITIES, AND PARTNERSHIPS UNDER THE CHNA WILL BE DELIVERED IN MANITOWOC COUNTY. FROEDTERT HOLY FAMILY MEMORIAL HOSPITAL DETERMINES ITS PRIMARY SERVICE AREA BY COMPLETING AN ANNUAL REVIEW AND ANALYSIS OF HOSPITAL DISCHARGES AND MARKET SHARE ACCORDING TO VARIOUS DETERMINANTS.THE FROEDTERT HOLY FAMILY MEMORIAL HOSPITAL TOTAL SERVICE AREA IN MANITOWOC COUNTY CONSISTS OF 14 ZIP CODES. 53015 (CLEVELAND), 53042 (KIEL), 53063 (NEWTON), 54207 (COLLINS), 54214 (FRANCIS CREEK), 54215 (KELLNERSVILLE), 54220 (MANITOWOC), 54227 (MARIBEL), 54228 (MISHICOT), 54230 (REEDSVILLE), 54232 (SAINT NAZIANZ), 54241 (TWO RIVERS), 54245 (VALDERS), 54247 (WHITELAW).FROEDTERT HOLY FAMILY MEMORIAL HOSPITALHOUSEHOLD INCOME CY20 PRIMARY SERVICE AREAUNDER $24,999..................18.59%$25,000-$49,999..................25.20%$50,000-$99,999..................37.77%$100,000 AND UP................18.44%TOTAL HOUSEHOLDS..............32,983PAYER SOURCE FY21 PRIMARY SERVICE AREACOMMERCIAL/MANAGED CARE........... 28.7%MEDICAID...........................12.4%MEDICARE...........................54.8%OTHER GOVERNMENT....................2.2%OTHER/SELF PAY......................1.8%SOURCE: WHARACE CY20 PRIMARY SERVICE AREAWHITE..............................92.13%AFRICAN AMERICAN....................1.04% ASIAN/HAWAIIAN/PACIFIC ISLANDER......0.03%NATIVE AMERICAN.....................0.61%TWO OR MORE RACES....................1.71%OTHER................................1.70%HISPANIC.............................4.15%TOTAL POPULATION.....................79,294PAYER SOURCE FY22Q3 PRIMARY SERVICE AREACOMMERCIAL/MANAGED CARE...................27.5%MEDICAID..................................12.6%MEDICARE..................................53.4%OTHER GOVERNMENT...........................3.0%OTHER/SELF PAY.............................3.5%SOURCE: WHA |
| PART VI, LINE 5 | THE BOARD OF DIRECTORS AT HOLY FAMILY MEMORIAL IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS. THEY ARE DEDICATED TO LEVERAGING THE BENEFITS OF OUR COMMUNITY THROUGH OUR HOSPITAL'S MISSION. THEY VALUE THE UNIQUE CHARACTER AND NEEDS OF THE PATIENTS AND COMMUNITIES WE SERVE AND THE PHYSICIANS WHO PROVIDE SPECIALTY CARE. HOLY FAMILY MEMORIAL'S COMMUNITY BOARD DEMONSTRATES OUR COMMITMENT TO QUALITY AND SERVICE. ANNUALLY, THE BOARD REVIEWS AND APPROVES THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT PLAN.ADDRESSING NEEDS THROUGH TARGETED OUTREACH:HOLY FAMILY MEMORIAL DEVELOPS AND EXECUTES COMMUNITY OUTREACH PROGRAMMING AND ACTIVITIES BASED ON IDENTIFIED COMMUNITY HEALTH NEEDS. EVERY NEEDS ASSESSMENT CYCLE, HOLY FAMILY MEMORIAL COMMUNITY ENGAGEMENT STAFF ALONG WITH THE HOSPITAL'S COMMUNITY PARTNERS AND OTHER LEADERS DEVELOPS A COMMUNITY HEALTH IMPROVEMENT PLAN THAT IS INCORPORATED INTO THE HOSPITAL'S OVERALL STRATEGIC PLAN TO ADDRESS THE MOST CRITICAL NEEDS IN THE COMMUNITIES WE SERVE. THE PLAN IS REVIEWED ANNUALLY BY THE HOLY FAMILY MEMORIAL BOARD OF DIRECTORS. HOLY FAMILY MEMORIAL COMMUNITY ENGAGEMENT STAFF, LEADERS AND EXTERNAL COMMUNITY PARTNERS WORK COLLABORATIVELY TO DEVELOP KEY GOALS AND STRATEGIES TO ADDRESS COMMUNITY HEALTH NEEDS. PROGRESS TOWARDS COMMUNITY OUTREACH PROGRAMS/ACTIVITIES AND GOALS ARE REPORTED ANNUALLY TO THE HOLY FAMILY MEMORIAL BOARD OF DIRECTORS, MISSION INTEGRATION COMMITTEE, AND AT LEADERSHIP MEETINGS. BASED ON THE RESULTS FROM THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, PROGRAMS AND ACTIVITIES ARE FOCUSED AROUND THE FOLLOWING IDENTIFIED HEALTH NEEDS:-ALCOHOL USE OR ABUSE-PRESCRIPTION OR OVER-THE-COUNTER DRUG ABUSE-OVERWEIGHT OR OBESITYFOR MORE INFORMATION ON SPECIFIC COMMUNITY OUTREACH EFFORTS, IMPLEMENTATION STRATEGY AND COMMUNITY HEALTH NEEDS ASSESSMENTS, PLEASE GO TO HOLY FAMILY MEMORIAL'S WEBSITE AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. |
| PART VI, LINE 6 | HOLY FAMILY MEMORIAL, IN AFFILIATION WITH THE FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN HEALTH NETWORK, IS THE RECOGNIZED LEADER AND LARGEST PROVIDER OF COMPREHENSIVE HEALTH CARE SERVICES IN MANITOWOC COUNTY. FOUNDED BY THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY, HOLY FAMILY MEMORIAL, ROOTED IN THE HEALING MINISTRY OF JESUS CHRIST, IS COMMITTED TO PROVIDING HIGH QUALITY MEDICAL CARE AND DEDICATED TO HELPING INDIVIDUALS IN THE COMMUNITIES HOLY FAMILY MEMORIAL SERVES ACHIEVE HEALTHIER LIVES. THE FROEDTERT & MCW HEALTH NETWORK OPERATES EASTERN WISCONSIN'S ONLY ACADEMIC MEDICAL CENTER AND ADULT LEVEL I TRAUMA CENTER AT FROEDTERT HOSPITAL, MILWAUKEE. IT ALSO INCLUDES EIGHT HOSPITAL LOCATIONS, NEARLY 2,000 PHYSICIANS AND MORE THAN 45 HEALTH CENTERS AND CLINICS.FROEDTERT MEMORIAL LUTHERAN HOSPITAL, FROEDTERT MENOMONEE FALLS, FROEDTERT WEST BEND HOSPITALS, FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC, AND HOLY FAMILY MEMORIAL MADE SIGNIFICANT INVESTMENTS IN THE HEALTH OF THEIR COMMUNITIES. PATIENTS WHO COULDN'T PAY FOR THEIR MEDICAL CARE RECEIVED MORE THAN $183 MILLION IN UNCOMPENSATED SERVICES. BEYOND PROVIDING CARE FOR THE UNINSURED/UNDERINSURED PATIENTS, WE CONTRIBUTED $129 MILLION TO IMPROVE ACCESS TO CARE, TEACH FUTURE HEALTHCARE PROFESSIONALS, DEVELOP NEW MEDICAL THERAPIES AND PARTICIPATE IN LOCAL PARTNERSHIPS AIMED AT REDUCING HEALTH DISPARITIES.FROEDTERT HEALTH MEMBERS DEVELOP COMMUNITY BENEFIT STRATEGIES AND GOALS BASED ON THE UNIQUE NEEDS OF EACH OF THEIR COMMUNITIES. BY CONDUCTING REGULAR COMMUNITY NEEDS ASSESSMENTS THAT MONITOR CRITICAL PUBLIC HEALTH ISSUES, AND ACTIVELY SEEKING COMMUNITY INPUT, THE HOSPITALS HAVE BUILT IMPORTANT LOCAL RELATIONSHIPS THAT PROVIDE MEANINGFUL OUTREACH PROGRAMS THAT LINK EACH HOSPITAL TO THEIR NEIGHBORS AND PATIENTS. AS A NOT-FOR-PROFIT HEALTH SYSTEM, FROEDTERT HEALTH REINVESTS ITS SURPLUS FUNDS BACK INTO THE COMMUNITY THROUGH PROGRAMS TO SERVE THE POOR AND UNINSURED, TEACH FUTURE HEALTHCARE PROFESSIONALS, DEVELOP NEW MEDICAL THERAPIES, MANAGE CHRONIC CONDITIONS LIKE DIABETES, HEALTH EDUCATION AND PROMOTION INITIATIVES, AND PARTICIPATE IN LOCAL PARTNERSHIPS AIMED AT REDUCING HEALTH DISPARITIES. FOR MORE INFORMATION ABOUT HOLY FAMILY MEMORIAL, VISIT HTTPS://WWW.HFMHEALTH.ORG/ AND FOR FROEDTERT HEALTH, VISIT WWW.FROEDTERT.COM |
| PART VI, LINE 7 | COMMUNITY BENEFIT DATA IS REPORTED ANNUALLY TO THE WISCONSIN HOSPITAL ASSOCIATION. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|---|---|
| BOYS & GIRLS CLUBS OF THE FOX VALLEY INC | ||||||||||
| PO BOX 756 | MANITOWOC | WI | 54221 | 391225709 | 501C(3) | $25,000 | $0 | FMV | N/A | PAYMENT FOR BENEFIT OF YOUNG PEOPLE BETWEEN AGES 6 - 12 |
| CAPITOL CIVIC CENTRE INC | ||||||||||
| PO BOX 399 | MANITOWOC | WI | 54221 | 391569595 | 501C(3) | $21,000 | $0 | FMV | N/A | ACT II CAMPAIGN - PAYMENT TO IMPROVE THE CENTRE'S BUILDING |
| PROGRESS LAKESHORE | ||||||||||
| 202 N 8TH ST SUITE 101 | MANITOWOC | WI | 54220 | 200419691 | 501C(6) | $13,000 | $0 | FMV | N/A | GENERAL SUPPORT |
| THE CHAMBER OF MANITOWOC COUNTY | ||||||||||
| 1515 MEMORIAL DRIVE | MANITOWOC | WI | 54220 | 390465570 | 501C(6) | $6,187 | $0 | FMV | N/A | HOLE SPONSORSHIP OF GOLF OUTING; SPONSORSHIP OF AWARDS OF DISTINCTION; TITLE SPONSOR OF FALL CONFERENCE |
| CITY OF MANITOWOC | ||||||||||
| 900 QUAY ST | MANITOWOC | WI | 54220 | 396005511 | $5,500 | $0 | FMV | N/A | HOLIDAY PARADE SPONSORSHIP; PAYMENT FOR MANITOWOC FAMILY AQUATIC CENTER CAPITAL CAMPAIGN | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
| Total Other Org | 2 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (3 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Cash GrantCashGrantAmt |
|---|---|---|---|---|---|
| MEDICAL ITEMS/SUPPLIES FOR THE NEEDY | 31 | $2,821 | FMV | MED ITEMS | |
| TRANSPORTATION FOR THE NEEDY | 82 | $2,027 | FMV | TAXI/OTHER TRANSPORT | |
| SCHOLARSHIPS | 6 | FMV | $12,000 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 2: | FOR GRANTS TO ORGANIZATIONS FOR PART II, GRANT REQUESTS FROM ORGANIZATIONS ARE MADE AND EVALUATED BASED ON THE BENEFIT PROVIDED TO A WIDE GROUP OF PEOPLE LIVING IN THE SERVICE AREA WHERE WE PROVIDE SERVICES AS WELL AS BEING OF A CHARITABLE OR PUBLIC BENEFIT TYPE NATURE. |
| PART III | HOLY FAMILY MEMORIAL MAINTAINS FILES OF THE GRANTS AWARDED ALONG WITH THE AMOUNT. AN APPLICATION FORM IS USED (IF APPLICABLE) FOR THE AWARD, WHICH INCLUDES A REVIEW OF INSURANCE AND EMPLOYMENT STATUS. PROVIDENCE FUNDS MAY ALSO BE USED IN EMERGENCY SITUATIONS TO PROVIDE FOOD, HOUSING, CLOTHING, AND MEDICAL SUPPLIES FOR SOMEONE STRANDED DUE TO AN ACCIDENT. GRANTS ARE AWARDED BASED ON MEDICAL AND FINANCIAL NEED. |
| PART-III LINE-(B) | THE RATIO OF A KNOWN COST TO A KNOWN RECIPIENT COUNT FOR EACH TYPE OF ASSISTANCE WAS APPLIED TO THE COSTS THAT DID NOT HAVE A SPECIFIC RECIPIENT NUMBER ASSIGNED FOR THAT ASSISTANCE TYPE TO ARRIVE AT AN ESTIMATED RECIPIENT VALUE FOR EACH ASSISTANCE TYPE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK BEHL | ||||||||||||||
| DIRECTOR & EVP/FH COO | $0 | $752,801 | $0 | $649,880 | $0 | $22,018 | $0 | $170,238 | $0 | $30,470 | $0 | $1,625,407 | $0 | $0 |
| RYAN M DOPIRAK MD | ||||||||||||||
| PHYSICIAN PROVIDER | $115,870 | $637,284 | $0 | $78,681 | $172 | $855 | $3,000 | $15,750 | $4,931 | $27,118 | $123,973 | $759,688 | $0 | $0 |
| RICHARD MANOS MD | ||||||||||||||
| PHYSICIAN PROVIDER | $118,470 | $651,476 | $0 | $0 | $404 | $2,107 | $0 | $3,588 | $3,889 | $21,393 | $122,763 | $678,564 | $0 | $0 |
| EDWARD L SMITH MD | ||||||||||||||
| PHYSICIAN PROVIDER | $101,568 | $604,120 | $0 | $0 | $125 | $654 | $13,373 | $10,343 | $3,889 | $21,393 | $118,955 | $636,510 | $0 | $0 |
| BRETT W NORELL | ||||||||||||||
| FORMER OFFICER | $73,831 | $9,322 | $0 | $135,132 | $2,109 | $435,024 | $23,151 | $11,186 | $3,890 | $0 | $102,981 | $590,664 | $0 | $135,132 |
| STEVEN LITTLE | ||||||||||||||
| SR. VP & PRESIDENT | $0 | $411,622 | $0 | $187,602 | $0 | $2,779 | $0 | $55,224 | $0 | $16,489 | $0 | $673,716 | $0 | $0 |
| JEFFREY VAN DE KREEKE | ||||||||||||||
| TREASURER | $0 | $332,666 | $0 | $181,985 | $0 | $79,880 | $0 | $18,675 | $0 | $16,322 | $0 | $629,528 | $0 | $0 |
| TROY D DAY | ||||||||||||||
| FORMER OFFICER | $44,576 | $177,190 | $0 | $162,648 | $191 | $104,359 | $13,535 | $36,125 | $180 | $720 | $58,482 | $481,042 | $0 | $116,335 |
| MATTHEW L CAMPBELL MD | ||||||||||||||
| DIRECTOR | $62,505 | $355,775 | $1,000 | $9,726 | $124 | $686 | $1,949 | $11,551 | $4,490 | $24,692 | $70,068 | $402,430 | $0 | $0 |
| MILAN JORDAN MD | ||||||||||||||
| DIRECTOR | $63,429 | $273,775 | $0 | $0 | $609 | $78,966 | $1,978 | $10,078 | $5,080 | $27,937 | $71,096 | $390,756 | $0 | $0 |
| THOMAS VEESER | ||||||||||||||
| CHIEF NURSING OFFICER | $34,513 | $170,989 | $0 | $0 | $328 | $15,106 | $11,057 | $30,757 | $4,277 | $23,521 | $50,175 | $240,373 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | COMPENSATION OF CEO/EXECUTIVE DIRECTOR ESTABLISHED BY RELATED ORGANIZATION, FROEDTERT HEALTH, THROUGH USE OF COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINES 4A-B | SEVERANCE PAYMENTS: DAY, TROY - $60,178 NORELL, BRETT - $389,639 457(F) PARTICIPANTS: BEHL, MARK DAY, TROY LITTLE, STEVEN NORELL, BRETT VAN DE KREEKE, JEFFREY VEESER, TOM 457(F) DISTRIBUTIONS: DAY, TROY - $116,335 NORELL, BRETT - $135,132 NON-QUALIFIED DISTRIBUTIONS: VAN DE KREEKE, JEFFREY - $44,967 (OF WHICH $0 WAS REPORTED AS DEFERRED ON A PRIOR FORM 990) NON-QUALIFIED PARTICIPANTS: VAN DE KREEKE, JEFFREY |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| CLAIRE JORDAN | |||
| SPOUSE OF DIRECTOR | $37,537 | EMPLOYMENT | 0 |
| DAWN KRUEGER | |||
| SPOUSE OF DIRECTOR | $114,239 | EMPLOYMENT | 0 |
| AMERICOLLECT INC | |||
| SEE PART V | $175,364 | SEE PART V | 0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV | FormAndLineReferenceDesc |
| Explanation | KENLYN T. GRETZ, DIRECTOR, WAS THE OWNER (80%) OF AMERICOLLECT, INC., WHICH PROVIDED SERVICES TO HFM IN THE AMOUNT OF $175,364. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | OUTPATIENT SERVICES: HOLY FAMILY MEMORIAL HAD 209,764 OUTPATIENT VISITS DURING THIS PERIOD. OUTPATIENT SURGERIES TOTALLED 2,110. CARDIOLOGY ENCOUNTERS WERE 1,818. ORTHO NOW PROVIDES SAME-DAY CARE FOR ORTHOPAEDIC AND SPORTS-RELATED INJURIES AT THE COST OF A CLINIC VISIT. FOOT AND ANKLE CLINIC: OUR TEAM INTEGRATES ALL ASPECTS OF SPECIALIZED CARE BY COLLECTIVELY COMBINING THEIR KNOWLEDGE, EXPERIENCE, AND EXPERTISE. WE BELIEVE THAT NO ONE SHOULD HAVE TO LIVE WITH ANKLE PAIN OR FOOT PAIN. WE WILL HELP YOU THROUGH EVERY STEP OF YOUR TREATMENT, WHETHER IT BE ORTHOTIC THERAPY OR CORRECTIVE SURGERY. FOOT AND ANKLE PAIN IS A COMMON DISORDER. ALMOST 80% OF THE POPULATION WILL EXPERIENCE FOOT PAIN IN THEIR LIVES. OUR TEAM IS TRAINED AND EQUIPPED TO DIAGNOSE AND TREAT ALL PROBLEMS INVOLVING THE FOOT AND ANKLE. WE TREAT PEOPLE OF ALL AGES, FOR PROBLEMS SUCH AS PLANTAR FASCIITIS, TENDONITIS AND BUNIONS, AS WELL AS SERIOUS INJURIES AND DISORDERS. MANY FOOT AND ANKLE PROBLEMS CAN BE REMEDIED WITH CONSERVATIVE CARE, INCLUDING CORRECTIVE ORTHOTIC DEVICES. FOR PATIENTS WITH CONDITIONS THAT FAIL TO RESPOND TO CONSERVATIVE CARE, SURGICAL INTERVENTION MAY BE NECESSARY. FOOT AND ANKLE SURGERY INCLUDES THE TREATMENT OF FRACTURES, REPAIR OF TENDON INJURIES, CORRECTION OF DEFORMITY, MANAGEMENT OF ANKLE INSTABILITY AND BONE/CARTILAGE FROM SPORTS-RELATED INJURIES, AND COMPREHENSIVE MANAGEMENT OF HEEL PAIN. WE ARE DEDICATED TO KEEPING OUR PATIENTS' FEET AND ANKLES IN THE HEALTHIEST CONDITIONS. IT IS OUR GOAL TO RELIEVE PATIENTS OF CHRONIC PAIN AND TO RETURN FUNCTION AND ENJOYMENT TO EVERYDAY ACTIVITY. BEHAVIORAL HEALTH SERVICES: FROM ALCOHOLISM AND OTHER DRUG ABUSE, TO ANXIETY, DEPRESSION, AND A RANGE OF OTHER MENTAL HEALTH ISSUES, OUR BEHAVIORAL HEALTH EXPERTS ARE HERE TO HELP YOU DEVELOP EFFECTIVE SKILLS TO: CHANGE UNHEALTHY OR ADDICTIVE BEHAVIORS, CONFRONT AND OVERCOME THE STRUGGLES OF GROWING UP, DEAL WITH THE EFFECTS OF SUBSTANCE ABUSE, FACE A TRAUMA AND THE STRESS AND ANXIETY IT MAY CAUSE, HANDLE LIFE CHANGES BROUGHT ON BY MARRIAGE, DIVORCE, OR THE DEATH OF A LOVED ONE, MANAGE DISRUPTIVE BEHAVIORAL PROBLEMS IN CHILDREN, INCLUDING ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD), SUCCESSFULLY COPE WITH ANXIETY, DEPRESSION, LOW ENERGY, LOW SELF-ESTEEM, AND LONELINESS, AND TAKE ON THE CHALLENGES OF RAISING A FAMILY. BEHAVIORAL HEALTH PROVIDES THE HIGHEST QUALITY CARE COMBINED WITH UNMATCHED COMPASSION AND SENSITIVITY. WE'RE PROUD TO OFFER A VARIETY OF PROVEN SERVICES AND TREATMENT OPTIONS FOR YOUR SPECIFIC NEEDS, INCLUDING: ALCOHOL AND OTHER DRUG ABUSE TREATMENTS; DEMENTIA/MEMORY ASSESSMENTS; DIALECTIC BEHAVIOR THERAPY (DBT) FOR PATIENTS WITH DIFFICULTY MANAGING THEIR EMOTIONS AND POTENTIALLY ENGAGING IN SELF-HARM; EYE MOVEMENT DESENSITIZATION AND REPROCESSING (EMDR) AND BRAINSPOTTING FOR TREATING TRAUMA-RELATED SYMPTOMS; INDIVIDUAL, FAMILY, AND GROUP COUNSELING; PSYCHIATRIC EVALUATIONS AND MEDICATION MANAGEMENT; AND SPECIFIC SERVICES AND TREATMENTS FOR CHILDREN AND ADOLESCENTS. ALCOHOLISM AND SUBSTANCE ABUSE ARE DISEASES. THEY DEVASTATE FAMILIES AND DESTROY LIVES EVERY DAY. AT BEHAVIORAL HEALTH, WE OFFER THE MOST COMPREHENSIVE OUTPATIENT SUBSTANCE ABUSE DISORDER TREATMENT SERVICES IN THE AREA PROVIDING EVERYTHING FROM ASSESSMENT AND OUTPATIENT COUNSELING, TO SPECIALIZED MEDICATION-ASSISTED TREATMENT (MAT). WE'RE EXPERTS IN WHAT WE DO, AND UNLIKE MANY PROVIDERS, ARE CERTIFIED TO PROVIDE MEDICATIONS TO ASSIST YOU BOTH IN REDUCING YOUR CRAVINGS AND URGES, AS WELL AS PREVENTING WITHDRAWAL SYMPTOMS. BECAUSE WE KNOW ADDICTION IS NOT WEAKNESS. IT'S NOT WILLFULNESS OR STUBBORNNESS. IT'S A CHRONIC AND RELAPSING BRAIN DISEASE, AND WE'RE HERE TO HELP YOU WITH EVERYTHING FROM TAKING THE FIRST STEP, TO DEVELOPING A LONG-TERM RECOVERY PLAN. DIAGNOSTIC IMAGING SERVICES: WHEN IT COMES TO DIAGNOSING AND TREATING DISEASES, THE RIGHT TECHNOLOGY MAKES A DIFFERENCE. HOLY FAMILY MEMORIAL IS TAKING THE LEAD IN BRINGING CUTTING-EDGE DIAGNOSTIC TECHNOLOGY TO YOU. OUR DIAGNOSTIC IMAGING SERVICES INCLUDE: CT SCAN (MANITOWOC COUNTY'S ONLY 64-SLICE CT SCANNER AND ONE OF THE FEW IN WISCONSIN TO PERFORM CT HEART SCANS); 3D MAMMOGRAPHY; SHORT-BORE MRI FEATURING MUSIC, AROMATHERAPY, AND OTHER CLAUSTROPHOBIA-REDUCING AMENITIES; ECHO-VASCULAR ULTRASOUND; PET/CT; AND NUCLEAR MEDICINE. EAR, NOSE, AND THROAT (ENT): AT EAR, NOSE, AND THROAT, OUR EXPERT TEAM SPECIALIZES IN QUICKLY DIAGNOSING AND EFFECTIVELY TREATING DISEASES AND DISORDERS AFFECTING THE HEAD AND NECK, FOR PATIENTS OF ALL AGES. FROM ALLERGIES TO EAR INFECTIONS, TO THYROIDS, TONSILS, AND SINUSES, WE'VE GOT YOU COVERED WITH THE RIGHT CARE FOR YOUR SPECIFIC NEEDS. HEARING AND BALANCE: AT HEARING AND BALANCE, WE KNOW THAT HEARING WELL IS VITAL TO THE WAY YOU EXPERIENCE LIFE. OUR EXPERT TEAM OF AUDIOLOGISTS SPECIALIZE IN EVALUATING YOUR HEARING AND HELPING YOU IMPROVE IT. AND IN ADDITION TO YOUR HEARING, WE ALSO OFFER BALANCE ASSESSMENTS TO ADDRESS ANY HEARING-RELATED BALANCE ISSUES YOU MAY BE EXPERIENCING. WE'RE PROUD TO OFFER COMPREHENSIVE HEARING AND BALANCE CARE, BECAUSE WE WANT YOU LIVING YOUR LIFE TO ITS FULLEST, NOT HINDERED BY HEARING OR BALANCE ISSUES. OUR COMPREHENSIVE AUDIOLOGY AND BALANCE SERVICES INCLUDE: ASSISTIVE LISTENING DEVICES; BALANCE/DIZZINESS EVALUATIONS; COMPREHENSIVE HEARING EVALUATIONS FOR ADULTS AND CHILDREN; HEARING AID FITTINGS; AND PROTECTIVE HEARING DEVICES. HOME HEALTH CARE: SKILLED NURSING SERVICES INCLUDE: INFUSION THERAPY; PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES; CARE AFTER SURGERY; COMPLEX WOUND CARE; MEDICATION MANAGEMENT; TELEMONITORING PROGRAM; MEDICAL SOCIAL WORK; AND HOME HEALTH AIDE. OTHER HOME CARE SERVICES INCLUDE: PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES; MEDICAL SOCIAL WORK; HOME HEALTH AID; AND CARE TAILORED TO THE NEEDS OF EACH PATIENT AND HIS/HER FAMILY. LABORATORY: OUR LEADING-EDGE HFM LABORATORY PROUDLY SERVES THE ENTIRE HFM NETWORK, AS WELL AS PROVIDING TESTING FOR MANY OUT-OF-NETWORK PROVIDERS AND HEALTHCARE ORGANIZATIONS. BECAUSE OUR PATIENTS AS WELL AS OTHER HEALTHCARE PROFESSIONALS KNOW THEY CAN PLACE THEIR TRUST IN US TO PROVIDE ACCURATE, RELIABLE RESULTS FAST. WE'RE CLINICAL LABORATORY IMPROVEMENT AMENDMENTS (CLIA) CERTIFIED, AND COLLEGE OF AMERICAN PATHOLOGISTS (CAP) ACCREDITED, AND OUR HIGHLY SPECIALIZED TEAM UTILIZES INNOVATIVE TECHNOLOGY TO PROVIDE YOU WITH THE RIGHT LABORATORY SERVICES AND THE RIGHT RESULTS. REHAB SERVICES: AT REHAB PLUS, WE'RE COMMITTED TO COLLABORATING WITH OUR PATIENTS AND PROVIDING THE RIGHT REHABILITATION CARE THROUGHOUT THEIR RECOVERY. OUR EXPERT TEAM OF HIGHLY SKILLED PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPISTS IS HERE TO WORK WITH YOU TO BUILD A PERSONALIZED PLAN TO MAXIMIZE YOUR FUNCTION AND MEET YOUR GOALS, WHETHER IT'S GETTING BACK TO COMPETITIVE ATHLETICS OR SIMPLY BUILDING STRENGTH TO GET OFF THE COUCH. WHILE THE ISSUES WE TREAT VARY GREATLY, OUR APPROACH REMAINS THE SAME. WE PROVIDE THE RIGHT CARE, IN THE RIGHT SETTING, FOR THE RIGHT OUTCOMES. PHYSICAL THERAPY: WITH A FOCUS ON RESTORING FUNCTION OF THE BODY FROM INJURY, SURGERY, OR SIMPLY PAIN, OUR LICENSED PHYSICAL THERAPY EXPERTS AT REHAB PLUS ARE HERE TO IDENTIFY THE CAUSE OF YOUR SYMPTOMS, EDUCATE YOU ON HOW TO BEST MANAGE THEM, AND WORK WITH YOU TO CREATE AN INDIVIDUALIZED PLAN TO IMPROVE YOUR FUNCTION AND QUALITY OF LIFE. STAFF ARE WELL TRAINED TO WORK WITH ALL POPULATIONS AND WILL CUSTOMIZE TREATMENT BASED UPON THE PATIENTS' EVALUATION. OUR TEAM HAS EXPERTISE IN TREATING A WIDE RANGE OF INJURIES AND ISSUES, INCLUDING: ARTHRITIS DISORDERS, CONCUSSIONS, CUMULATIVE TRAUMA DISORDERS, FOOT PAIN, GAIT AND BALANCE DISORDERS, HEADACHES, IMPROVING ATHLETIC PERFORMANCE, LOW BACK AND NECK PAIN, MUSCLE AND JOINT STRAINS AND SPRAINS, NEUROLOGICAL DISORDERS, PRE AND POSTOPERATIVE ORTHOPAEDIC CONDITIONS, SPORTS AND RECREATIONAL INJURIES, STROKE/CVA, TMJ DISORDERS, VESTIBULAR DISORDERS, AND WORK-RELATED INJURIES. |
| PART III, LINE 4A (CONT) | OUR PROVEN, EVIDENCE-BASED TREATMENT OPTIONS INCLUDE: AQUATIC POOL THERAPY, AUGMENTED SOFT TISSUE MOBILIZATION, MANUAL THERAPY TECHNIQUES TO ADDRESS MUSCLE AND JOINT ISSUES, MODALITIES INCLUDING ULTRASOUNDS AND IONTOPHORESIS, AND SPECIFIC EXERCISES TO REDUCE PAIN AND IMPROVE FUNCTION. AND BECAUSE WE'RE COMMITTED TO PROVIDING THE RIGHT CARE TO ANY PATIENT IN NEED, OUR PHYSICAL THERAPY SERVICES ARE AVAILABLE WITHOUT A PHYSICIAN'S REFERRAL THROUGH OUR DIRECT ACCESS THERAPY PROGRAM. OCCUPATIONAL THERAPY: AT REHAB PLUS, WE ALSO OFFER COMPREHENSIVE OUTPATIENT OCCUPATIONAL THERAPY IF YOU'RE EXPERIENCING A PHYSICAL DISABILITY OR DYSFUNCTION OF YOUR HAND, WRIST, OR ARM. OUR LICENSED OCCUPATIONAL THERAPISTS, CERTIFIED HAND THERAPISTS, AND CERTIFIED OCCUPATIONAL THERAPY ASSISTANTS ARE EXPERTS IN THE EVALUATION AND TREATMENT OF: ANKLE AND LEG SWELLING, ARTHRITIS DISORDERS OF THE HAND, WRIST, AND ARM, COGNITIVE DISABILITIES RESULTING FROM A HEAD INJURY, HAND, WRIST AND ELBOW INJURIES, STROKE/CVA, AND UPPER BODY, WORK-RELATED INJURIES AND CUMULATIVE TRAUMA DISORDERS. BASED ON YOUR SPECIFIC DIAGNOSIS AND NEEDS, OUR TEAM IS EXPERIENCED IN A VARIETY OF PROCEDURES AND TREATMENTS, INCLUDING: CUSTOM HAND, WRIST AND ARM SPLINTING, LYMPHEDEMA MANAGEMENT, AND MANUAL THERAPY AND PERSONALIZED EXERCISE TECHNIQUES. SPEECH THERAPY: OUR LICENSED SPEECH PATHOLOGISTS ARE SPECIALLY TRAINED TO EVALUATE AND TREAT CHILDREN AND ADULTS WITH SPEECH, LANGUAGE, AND SWALLOWING PROBLEMS. WE'RE HERE TO PROVIDE EXPERT CARE FOR: COGNITIVE DISORDERS FOLLOWING TBI, DEVELOPING AUGMENTATIVE COMMUNICATION SYSTEMS, FLUENCY (STUTTERING) THERAPY, SPEECH AND SWALLOWING ISSUES ASSOCIATED WITH EVERYTHING FROM A STROKE/CVA TO NEUROLOGICAL DISEASE, TREATMENT FOLLOWING HEAD/NECK CANCER, VOCAL DISORDERS ASSOCIATED WITH GERD, AND VOICE DISORDER TREATMENT. OUR SPEECH THERAPY TEAM ALSO OFFERS SPECIALTY SERVICES WHEN REQUIRED, INCLUDING MODIFIED BARIUM SWALLOW STUDIES. SPECIALTY REHAB SERVICES: AT HFM REHAB PLUS, WE'RE COMMITTED TO STAYING ON THE LEADING-EDGE OF REHAB TREATMENTS AND SERVICES. WE'RE PROUD TO OFFER AN ARRAY OF SPECIALTY REHAB SERVICES, INCLUDING: AQUATIC THERAPY, ASTYM THERAPY, BLOOD FLOW RESTRICTION, CONCUSSION CARE, DRY NEEDLING, FUNCTIONAL CAPACITY EVALUATIONS, HFM SURVIVORSHIP AND REHAB PROGRAM, HOME CARE SERVICES, LYMPHEDEMA THERAPY, MODIFIED BARIUM SWALLOW STUDIES, PEDIATRIC THERAPY, PELVIC FLOOR AND INCONTINENCE REHABILITATION, SELF-PAY THERAPY SERVICES, VESTIBULAR REHABILITATION, AND WORK CONDITIONING. SLEEP CLINIC: AT HOLY FAMILY MEMORIAL, WE OFFER A VARIETY OF SLEEP STUDIES AND SCREENINGS FOR THE SPECTRUM OF SLEEP DISORDERS. FROM SIMPLE, AT-HOME SCREENINGS TO IN-DEPTH DIAGNOSTIC SLEEP STUDIES, WE'VE GOT YOU COVERED. AND YOU HAVE OPTIONS. MOST DIAGNOSTIC SLEEP STUDIES CAN BE PERFORMED EITHER OVERNIGHT AT OUR FROEDTERT HOLY FAMILY MEMORIAL HOSPITAL, OR AS A HOME SLEEP STUDY. WOUND CARE: AT WOUND CLINIC, WE'RE COMMITTED TO PROVIDING YOU WITH THE RIGHT CARE, TAILORED TO YOUR SPECIFIC CONDITION. YOUR INDIVIDUALIZED WOUND CARE TREATMENT PLAN MAY INCLUDE SOME OR ALL OF THESE TREATMENTS AND TECHNIQUES: ANTIBIOTIC THERAPY, APPLICATION OF SPECIALTY DRESSINGS AND/OR OINTMENTS, LABORATORY STUDIES, NUTRITIONAL COUNSELING AND/OR SUPPLEMENTS, PHYSICAL THERAPY, SURGICAL DEBRIDEMENT TO REMOVE INFECTED TISSUE AND/OR BONE, USE OF CRUTCHES, WHEELCHAIR, OR OTHER OFF-LOADING TECHNIQUES, VASCULAR STUDIES, AND X-RAYS. OUR WOUND CLINIC IS ALSO PROUD TO OFFER ADDITIONAL CARE SERVICES, INCLUDING: GENERAL OSTOMY CARE, HOSPITAL DISCHARGE FOLLOW-UP FOR NEW OR REVISED OSTOMIES, PREOPERATIVE OSTOMY SITE MARKING AND EDUCATION, AND POSTOPERATIVE OSTOMY EDUCATION AND CARE. |
| FORM 990, PART III, LINE 4B, DESCRIPTION OF PROGRAM SERVICE: | INPATIENT SERVICES: HOLY FAMILY MEMORIAL IS AN INTEGRATED NETWORK PROVIDING HEALTH CARE SERVICES INTENDED TO BENEFIT THE HEALTH AND WELLBEING OF THE COMMUNITIES IT SERVES. THESE SERVICES INCLUDE PRIMARY AND SPECIALTY CLINIC CARE, PREVENTIVE CARE SUCH AS HEALTH SCREENINGS, VACCINATION CLINICS AND HEALTH EDUCATION CLASSES, 24/7 EMERGENCY CARE, WALK-IN, INPATIENT ACUTE CARE, OUTPATIENT CARE, HOME CARE AND HOSPICE, PRESCRIPTIONS, OCCUPATIONAL HEALTH SERVICES, AND MEDICALLY BASED FITNESS AND WELLNESS. HOLY FAMILY MEMORIAL HAS BEEN ABLE TO ACHIEVE A GREATER IMPACT IN THE COMMUNITY BY PARTNERING FINANCIAL, HUMAN AND PROGRAMMATIC RESOURCES WITH OTHER ORGANIZATIONS. THESE PARTNERSHIPS INCLUDE A COMMITMENT TO COLLABORATE WITH OTHER HEALTH AND SOCIAL SERVICE AGENCIES TO IMPROVE ACCESS TO CARE, FOCUS ON PREVENTIVE SERVICES, REDUCE COMMUNITY HEALTH RISKS, AND CONTRIBUTE TO A HEALTHIER, VIBRANT COMMUNITY. HOLY FAMILY MEMORIAL PROVIDES MEDICALLY NECESSARY SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICIES. IN ASSESSING A PATIENT'S ABILITY TO PAY, HFM UTILIZES GENERALLY RECOGNIZED POVERTY INCOME LEVELS OF THE COMMUNITIES IT SERVES, AND CONSIDERS SITUATIONS WHERE INCURRED CHARGES ARE SIGNIFICANT WHEN COMPARED TO THE PATIENT'S FINANCIAL RESOURCES. BECAUSE HFM DOES NOT EXPECT TO RECEIVE PAYMENT OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT INCLUDED IN NET PATIENT SERVICE REVENUES. HOLY FAMILY MEMORIAL'S TOTAL COMMUNITY BENEFIT INCLUDES THE COST OF CHARITY CARE AND UNPAID COST OF PUBLIC PROGRAMS (MEDICARE AND MEDICAID) AS WELL AS THOSE DISCUSSED ABOVE. HOLY FAMILY MEMORIAL'S COMMUNITY BENEFIT WAS APPROXIMATELY $18,223,000 FOR THE PERIOD ENDED JUNE 30, 2022. THIS AMOUNT INCLUDES THE NET COST OF CHARITY CARE OF APPROXIMATELY $276,000. MORE INFORMATION IS AVAILABLE FROM OUR COMMUNITY BENEFIT REPORT WHICH IS LOCATED ON OUR WEBSITE AT WWW.HFMHEALTH.ORG WHEN THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY WAS APPROACHED BY LOCAL CLERGY AND COMMUNITY LEADERS OVER A CENTURY AGO TO CARE FOR THE HEALTH NEEDS OF OUR GROWING COMMUNITY IN THE MANITOWOC AREA, THEY ANSWERED THE CALL. HOLY FAMILY MEMORIAL WAS FOUNDED IN 1899 WITH A MISSION TO SERVE OUR COMMUNITY'S UNIQUE NEEDS. AS HEALTHCARE HAS EVOLVED AND AS OUR COMMUNITY HAS GROWN, SO HAVE WE. BUT OUR MISSION REMAINS THE SAME. AND WE'VE BEEN PROUDLY SERVING OUR COMMUNITY EVER SINCE. ROOTED IN THE FRANCISCAN TRADITION OF HOSPITALITY AND THE HEALING MINISTRY OF JESUS CHRIST, HOLY FAMILY MEMORIAL HAS A RICH HERITAGE OF PUTTING OUR COMMUNITY FIRST. WE'RE COMMITTED TO PROVIDING THE RIGHT CARE, IN THE RIGHT SETTING, FOR THE RIGHT OUTCOMES. TODAY, WE'RE RECOGNIZED AS THE LEADER AND LARGEST PROVIDER OF HEALTHCARE SERVICES IN MANITOWOC COUNTY. OUR NETWORK OF MORE THAN 830 HEALTHCARE PROFESSIONALS PROUDLY PROVIDES OUR COMMUNITY WITH TOP QUALITY, PERSONALIZED CARE. HOLY FAMILY MEMORIAL INCLUDES AN INPATIENT AND OUTPATIENT MEDICAL CENTER, SPECIALTY AND WALK-IN CARE, AND MORE THAN 10 CLINICS. CANCER CAN BE A LIFE-CHANGING DIAGNOSIS. BUT LIFE DOESN'T STOP. AND NEITHER DO WE. OUR CANCER CENTER TEAM IS HERE AND READY TO WALK WITH YOU THROUGH YOUR JOURNEY, ALWAYS FOCUSED ON YOU AND THE RIGHT OUTCOME. THROUGH OUR CANCER CENTER, WE OFFER INNOVATIVE, COLLABORATIVE, COMPREHENSIVE CANCER SERVICES TO CARE FOR YOUR PHYSICAL, SPIRITUAL, AND EMOTIONAL NEEDS. AT ORTHOPAEDICS, WE'RE HERE TO HELP YOU GET BACK TO DOING WHAT YOU LOVE. OUR DEDICATED TEAM OF ORTHOPAEDIC EXPERTS DELIVERS ORTHOPAEDIC EXCELLENCE TO EACH OF OUR PATIENTS. WE'RE PROUD TO BE RECOGNIZED AS THE REGION'S PREMIER ORTHOPAEDIC PROVIDER, A DISTINCTION WE'VE HELD FOR MORE THAN A DECADE. AT WOMEN'S HEALTH, WE'RE DEDICATED TO PROVIDING COMPREHENSIVE HEALTHCARE FOR WOMEN THROUGHOUT EVERY LIFE STAGE. WHETHER YOU'RE WELCOMING YOUR FIRST BABY INTO THE WORLD, SCHEDULING YOUR FIRST MAMMOGRAM, APPROACHING MENOPAUSE, OR JUST TRYING TO IMPROVE YOUR HEALTH AND WELL-BEING, WE'RE HERE TO PROVIDE YOU WITH SERVICES AND SUPPORT FOR ALL OF YOUR UNIQUE HEALTHCARE NEEDS. WHILE THE SPECIFIC TYPE OF CARE YOU NEED MAY CHANGE AS YOU GO THROUGH DIFFERENT LIFE STAGES, THE NEED FOR EXPERT, COMPASSIONATE, AND SPECIALIZED CARE DOESN'T. HEART AND VASCULAR CENTER PROVIDES TOP-QUALITY, COMPREHENSIVE CARDIAC CARE TO OUR COMMUNITY. FEATURING AN AWARD-WINNING CARDIAC CATH LAB, THE ONLY ONE OF ITS KIND IN MANITOWOC AND SHEBOYGAN COUNTIES, OUR TEAM QUICKLY AND EXPERTLY DIAGNOSES, TREATS, AND MANAGES EVERYTHING FROM CHEST PAIN, HEART ATTACKS, AND CONGESTIVE HEART FAILURE, TO CORONARY ARTERY DISEASE, MYOCARDIAL INFARCTION, ARRHYTHMIAS, AND HYPERTENSION. AT HOLY FAMILY MEMORIAL, YOU RECEIVE WORLD-CLASS, FAITH-BASED HEALTHCARE RIGHT IN YOUR OWN COMMUNITY. YOU DON'T HAVE TO TRAVEL TO A LARGER MARKET NETWORK TO GET BETTER QUALITY OF CARE SINCE WE'RE RIGHT HERE, JUST MINUTES FROM YOUR HOME, WORKING HARD TO EXCEED REGIONAL AND NATIONAL STANDARDS EVERY DAY. IT'S OUR PROMISE TO YOU TOO, TO PROVIDE THE RIGHT CARE, IN THE RIGHT SETTING, FOR THE RIGHT OUTCOMES. OUR EVER-GROWING LIST OF AWARDS, ACCOLADES, ACCREDITATIONS, AND RECOGNITION DEMONSTRATE OUR COMMITMENT TO EXCELLENCE AND OUR DEDICATION TO OUR PATIENTS AND OUR COMMUNITY. IN MARCH 2021, HFM FINALIZED AN AFFILIATION AGREEMENT WITH FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN, STARTING THE NEXT CHAPTER IN CONTINUING TO IMPROVE OUR OFFERING OF HEALTHCARE TO THE MANITOWOC AREA. WORKING TOGETHER, WE'RE MAKING MORE OF WHAT IS HUMANLY POSSIBLE FOR YOUR HEALTH CARE AVAILABLE CLOSER TO HOME IN MANITOWOC COUNTY. IT'S A PARTNERSHIP THAT BUILDS ON THE RICH LEGACY OF HOLY FAMILY MEMORIAL AND SECURES IT FOR YEARS TO COME BY ADDING THE BROAD RESOURCES OF THE FROEDTERT AND MCW ACADEMIC HEALTH NETWORK TO BRING MORE HEALTH CARE OPTIONS TO THE COMMUNITY. IT'S A BEST-OF-BOTH-WORLDS SCENARIO FOR LOCAL RESIDENTS, AS MANITOWOC COUNTY'S TRUSTED HEALTH CARE PROVIDER PARTNERS WITH EASTERN WISCONSIN'S ONLY ACADEMIC HEALTH NETWORK TO OFFER EASY, LOCAL CONNECTIONS TO HIGH-CALIBER COMPLEX AND SPECIALTY CARE. BY WORKING TOGETHER, THE ENTIRE COMMUNITY BENEFITS, TOO. AS NONPROFIT ORGANIZATIONS, WE REMAIN COMMITTED TO REINVESTING ALL REVENUE OVER EXPENSES INTO OUR PEOPLE, FACILITIES, TECHNOLOGY, AND STRATEGIES TO SUPPORT OUR SHARED MISSION TO ADVANCE THE HEALTH OF THOSE WE SERVE NOW AND IN THE FUTURE. IT'S A MISSION STARTED WHEN THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY MINISTRY FOUNDED HOLY FAMILY MEMORIAL AND ONE THAT REFLECTS THE VALUES LONG SUPPORTED BY THE FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN HEALTH NETWORK. INPATIENT SERVICES: HOLY FAMILY MEMORIAL HAS 58 INPATIENT BEDS. FOR THE 12 MONTHS ENDED JUNE 30, 2022 WE HAD 1,502 ADMISSIONS WITH 8,379 PATIENT DAYS OF CARE. INPATIENT SURGERIES WERE 387. DURING FISCAL YEAR 2022, THE HOSPITAL HAD 215 CANCER REGISTRY CASES. SURGICAL SERVICES: WE HAVE SURGICAL SPECIALISTS IN A VARIETY OF FIELDS TO MEET ALL OF THE SURGICAL NEEDS OF OUR COMMUNITY, INCLUDING: CANCER TREATMENT - SCREENINGS AND SURGICAL PROCEDURES FOR COMMON CANCERS, INCLUDING: COLORECTAL, BREAST, ESOPHAGUS, STOMACH, LUNG, LIVER, SKIN, OVARIAN, THYROID AND OTHERS; EAR, NOSE, AND THROAT (ENT) SURGERY - TUBES IN EARS, REMOVE TONSILS, SEPTUM REPAIR OR REPOSITION, TURBINATE REDUCTION SURGERY, AND ENDOSCOPIC SINUS SURGERY; GENERAL SURGERY - HERNIA REPAIR, GALL BLADDER REMOVAL, VARICOSE VEIN REPAIR; GYNECOLOGICAL SURGERY - HYSTERECTOMIES, INCONTINENCE TREATMENT, ENDOMETRIAL ABLATION; ORTHOPAEDIC SURGERY - JOINT REPLACEMENTS, SPORTS MEDICINE INJURY REPAIR; AND UROLOGICAL SURGERY - INCONTINENCE TREATMENT, ENLARGED PROSTATE TREATMENT. THE HEART AND VASCULAR CENTER IS A PROVIDER OF TOP-QUALITY, COMPREHENSIVE CARDIAC CARE IN MANITOWOC COUNTY. FEATURING AN AWARD-WINNING CARDIAC CATH LAB, OUR TEAM QUICKLY AND EXPERTLY DIAGNOSES, TREATS, AND MANAGES EVERYTHING FROM CHEST PAIN, HEART ATTACKS, AND CONGESTIVE HEART FAILURE, TO CORONARY ARTERY DISEASE, MYOCARDIAL INFARCTION, ARRHYTHMIAS, AND HYPERTENSION. AT HOLY FAMILY MEMORIAL, OUR AWARD-WINNING, NATIONALLY RECOGNIZED CARDIAC CATH LAB IS HERE AND READY WHEN YOU NEED US WITH THE RAPID RESPONSE AND EXPERTISE YOU CAN DEPEND ON. OUR INNOVATIVE X-RAY SYSTEM AT HFM IS ONE OF THE MOST ADVANCED IN THE NATION. IT CUTS RADIATION EXPOSURE TO PATIENTS BY 73% WHILE MAINTAINING IMAGE QUALITY AND IS ABLE TO ADJUST IN REAL-TIME TO THE DEPTH AND AREA BEING VIEWED. |
| PART III, LINE 4B (CONT) | WHEN IT COMES TO A HEART ATTACK, EVERY MINUTE MATTERS. WHEN DEALING WITH HEART ATTACKS, YOU OFTEN HEAR THE TERM, "DOOR-TO-BALLOON TIME." THIS REFERS TO THE AMOUNT OF TIME BETWEEN WHEN A PATIENT ARRIVES AT THE HOSPITAL TO THE TIME THEY RECEIVE NECESSARY TREATMENT TO OPEN A BLOCKED HEART VESSEL. HFM'S DOOR-TO-BALLOON TIME CONSISTENTLY BEATS NATIONAL AVERAGES. OUR AVERAGE TIME IS 30 MINUTES, AND WE OFTENTIMES CLOCK IN UNDER 15 MINUTES. IT'S THIS COMMITMENT TO SPEED AND EXCELLENCE THAT'S LED US TO RECEIVING NATIONAL AWARDS AND RECOGNITION. THE AMERICAN HEART ASSOCIATION HAS HONORED HOLY FAMILY MEMORIAL WITH TWO MISSION: LIFELINE AWARDS, FOR EXCELLENCE IN IMPROVING QUALITY OF CARE FOR HEART ATTACK PATIENTS. HFM HAS ALSO BEEN AWARDED THE PLATINUM PERFORMANCE ACHIEVEMENT AWARD FROM THE AMERICAN COLLEGE OF CARDIOLOGY AND IS ACCREDITED BY THE AMERICAN HEART ASSOCIATION AND THE SOCIETY OF CARDIOVASCULAR PATIENT CARE. HFM'S LEADING-EDGE CARDIODIAGNOSTICS DEPARTMENT PROVIDES A NUMBER OF SERVICES TO DIAGNOSE HEART CONDITIONS, INCLUDING: ECHOCARDIOGRAPHY (INCLUDING TRANSESOPHAGEAL ECHOCARDIOGRAPHY); EKG; EVENT MONITORING; STRESS TESTING; HOLTER MONITORING; AND NUCLEAR MEDICINE CARDIAC IMAGING. TOTAL JOINT REPLACEMENT CLINIC: WE WORK WITH PATIENTS TO IDENTIFY AND DIAGNOSE THEIR BONE OR JOINT PROBLEM, LISTEN TO THEIR CONCERNS, IDENTIFY THEIR GOALS, AND CREATE AN INDIVIDUALIZED TREATMENT PLAN. OFTENTIMES, SURGERY IS NOT REQUIRED, AND PATIENTS CAN BE TREATED WITH THE FOLLOWING THERAPIES AND RECOMMENDATIONS: ANTI-INFLAMMATORY MEDICATIONS; KNEE BRACES; WALKING DEVICES; EXERCISE AND/OR PHYSICAL THERAPY; ICE FOLLOWING CERTAIN ACTIVITIES; WEIGHT REDUCTION FOR THOSE OVERWEIGHT; HYALURONIC ACID THERAPY; AND REST OR ACTIVITY MODIFICATION, OUR ADVANCED DIAGNOSTIC CAPABILITIES AND STATE-OF-THE-ART TECHNOLOGY HELP US MAKE AN ACCURATE DIAGNOSIS FOR EACH PATIENT. WE USE RESOURCES SUCH AS MAGNETIC RESONANCE IMAGING (MRI), CT SCANS, ELECTROMYOGRAPHY (EMG), MOTION AND GAIT ANALYSIS. WE ARE THE ONLY PROVIDER IN NORTHEASTERN WISCONSIN OFFERING KNEEKG TO HELP ASSESS CONDITIONS THAT MAY REQUIRE JOINT REPLACEMENT. JOINT REPLACEMENT SURGERY CAN BE AN EFFECTIVE WAY TO ELIMINATE PAIN AND DRAMATICALLY IMPROVE A PATIENT'S QUALITY OF LIFE. JOINT REPLACEMENT SURGERY IS GENERALLY CONSIDERED ONLY AFTER OTHER TREATMENTS HAVE BEEN TRIED FIRST. A VARIETY OF SURGERIES ARE OFFERED INCLUDING: ANTERIOR HIP REPLACEMENT; REVISION HIP AND KNEE REPLACEMENT; MUSCLE SPARING JOINT REPLACEMENT; RAPID RECOVERY JOINT REPLACEMENT; NARCOTIC-FREE AND MINIMALLY INVASIVE TOTAL KNEE REPLACEMENT; GENDER-SPECIFIC KNEE REPLACEMENT; NO PRECAUTION TOTAL HIP REPLACEMENT; AND VISCOSUPPLEMENTATION. CANCER SERVICES: MEDICAL ONCOLOGY AND HEMATOLOGY TREATS THE FULL SPECTRUM OF CANCER DIAGNOSES USING CHEMOTHERAPY, BIOLOGIC RESPONSE MODIFIERS, TARGETED THERAPIES, AND IMMUNOTHERAPY. SUPPORTIVE SERVICES PROVIDED FOR THESE TREATMENTS MAY INCLUDE BONE MARROW BIOPSY, BLOOD TRANSFUSIONS, HYDRATION, AND NAUSEA OR PAIN MANAGEMENT THERAPIES. RADIATION ONCOLOGY PROVIDES A FULL RANGE OF EXTERNAL BEAM RADIATION FOR ALL ADULT MALIGNANCIES, SOME ADOLESCENT MALIGNANCIES, AND SELECT BENIGN CONDITIONS. THE CANCER CENTER IS HOME TO THE ONLY TOMOTHERAPY UNIT IN BROWN, CALUMET, MANITOWOC, AND SHEBOYGAN COUNTIES. TOMOTHERAPY IS A CUTTING-EDGE TECHNOLOGY DESIGNED TO EFFECTIVELY TREAT HARD-TO-REACH AND COMPLEX TUMORS BY DELIVERING EXACT, INTENSE RADIATION. IT PRECISELY TARGETS THE TUMOR FROM ALL ANGLES ALLOWING HIGHER DOSES OF RADIATION TO BE GIVEN TO THE TUMOR, WHILE REDUCING THE RADIATION EXPOSURE OF HEALTHY TISSUE. CT IMAGING IS USED TO GUIDE TREATMENT. SURGICAL SERVICES ARE ONE OF THE PRIMARY METHODS USED IN CANCER DIAGNOSIS AND TREATMENT. HFM HAS A COMPREHENSIVE SURGICAL DEPARTMENT THAT IS EQUIPPED TO PERFORM NEWER CANCER PROCEDURES, INCLUDING SENTINEL NODE MAPPING AND BIOPSY AND STEREOTACTIC BREAST BIOPSIES. GASTROENTEROLOGY: AT GASTROENTEROLOGY, WE'RE HERE TO PROVIDE YOU WITH ANSWERS FOR ALL OF YOUR GASTROINTESTINAL CONCERNS IN TERMS YOU'LL UNDERSTAND, ALONG WITH THE EXPERT CARE YOU DESERVE. OUR TEAM OF INDUSTRY-LEADING GASTROENTEROLOGISTS COMBINE YEARS OF EXPERIENCE WITH CUTTING-EDGE TECHNOLOGY TO QUICKLY DIAGNOSE AND EFFECTIVELY TREAT ANY DIGESTIVE SYSTEM DISORDER. HERE ARE JUST SOME OF THE DIGESTIVE CONDITIONS WE TREAT: ACID REFLUX; BARRETT'S ESOPHAGUS; BILE DUCT DISORDERS; CELIAC DISEASE; CIRRHOSIS; COLON CANCER SCREENING (COLONOSCOPY); COMMON BILE DUCT STONES; CONSTIPATION; CROHN'S DISEASE; DIARRHEA; DIVERTICULITIS; DYSPHAGIA; ESOPHAGITIS; GALLBLADDER DISORDERS; GASTROESOPHAGEAL REFLUX DISEASE (GERD); GASTROINTESTINAL BLEEDING; GASTRITIS; HEPATITIS B AND C; IRRITABLE BOWEL SYNDROME (IBS); INFLAMMATORY BOWEL DISEASE (IBD); LIVER DISEASES (BOTH VIRAL AND INHERITABLE); PANCREATITIS; PEPTIC ULCER DISEASE; AND ULCERATIVE COLITIS. BIRTHING SERVICES: THE BIRTH OF A CHILD IS ONE OF THE MOST EXCITING, JOYOUS EVENTS LIFE HAS TO OFFER. OUR EXPERIENCED, BOARD-CERTIFIED DOCTORS AND CARING STAFF LOOK FORWARD TO HELPING PATIENTS AND THEIR FAMILY TO HAVE THE MOST MEMORABLE AND POSITIVE BIRTH EXPERIENCE. EVERY PREGNANCY IS UNIQUE. THAT'S WHY WE WORK CLOSELY WITH OUR PATIENTS TO PERSONALIZE EACH BIRTH PLAN AND PROVIDE ADDITIONAL SERVICES THAT MAY BE NEEDED TO PREPARE FOR PREGNANCY, LABOR, DELIVERY, AND POSTPARTUM CARE. DURING THIS REPORTING PERIOD, HFM HAD 70 BIRTHS. |
| FORM 990, PART III, LINE 4C | EMERGENCY SERVICES: DURING THE 12 MONTHS ENDED JUNE 30, 2022, WE HAD 10,375 EMERGENCY VISITS. THE EMERGENCY DEPARTMENT OFFERS MANITOWOC COUNTY THE MOST COMPREHENSIVE EMERGENCY SERVICES IN THE AREA. WE ARE A LEVEL III TRAUMA CENTER. WITH A TEAM OF FULL-TIME, EMERGENCY MEDICINE PHYSICIANS AND SPECIALLY TRAINED ACLS-CERTIFIED NURSES, PATIENTS WILL RECEIVE THE HIGHEST LEVEL OF CARE. HFM ALSO OFFERS A 10-BED INTENSIVE CARE UNIT STAFFED BY HIGHLY TRAINED NURSES AND MONITOR TECHNICIANS. IN OUR INTENSIVE CARE UNIT: RNS ARE CERTIFIED IN ADVANCED CARDIAC LIFE SUPPORT; CHEST PAIN PROTOCOLS INITIATED IN THE EMERGENCY ROOM ARE CONTINUED AND A WORK UP FOR CARDIAC DISEASE CAN OFTEN BE COMPLETED IN 12-24 HOURS; STATE-OF-THE-ART MONITORING EQUIPMENT IS USED, INCLUDING INTRA-AORTIC BALLOON PUMPS; AND WE BRING THE ELEMENT OF HUMAN CARING TO A HIGHLY TECHNICAL AREA. |
| FORM 990, PART I, LINE 5 AND PART V, LINE 2 | FROEDTERT HEALTH, INC. IS THE COMMON LAW EMPLOYER FOR THE FROEDTERT HEALTH SYSTEM WHICH INCLUDES HOLY FAMILY MEMORIAL, INC. |
| FORM 990, PART VI, SECTION A, LINE 2 | JEFFREY VAN DE KREEKE, STEVE LITTLE, AND THOMAS VEESER HAVE A BUSINESS RELATIONSHIP WITH MARK BEHL. |
| FORM 990, PART VI, SECTION A, LINE 6 | AS OF MARCH 1, 2021, BFHFM, LLC OWNS 80% OF HFM AS A CORPORATE MEMBER. PRIOR TO MARCH 1, 2021, HOLY FAMILY MEMORIAL WAS SPONSORED BY FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC. (FSCCSM). AS OF MARCH 1, 2021, FSCCSM RETAINS A 20% INTEREST IN HFM. BFHFM, LLC AND FSCCSM, INC. ARE THE TWO CORPORATE MEMBERS OF HFM. FROEDTERT HEALTH INC. OWNS 100% OF BFHFM, LLC. |
| FORM 990, PART VI, SECTION A, LINE 7A | HOLY FAMILY MEMORIAL OPERATES AN INTEGRATED HEALTHCARE DELIVERY SYSTEM, PRIMARILY TO THE RESIDENTS OF MANITOWOC COUNTY, WISCONSIN. HOLY FAMILY MEMORIAL'S BOARD OF DIRECTORS SHALL CONSIST OF NO MORE THAN SEVENTEEN INDIVIDUALS. THE PRESIDENT OF THE CORPORATION, THE CHIEF OF THE CORPORATION'S MEDICAL STAFF, AND THE CHIEF NURSING OFFICER SHALL BE EX-OFFICIO MEMBERS WITH FULL VOTING PRIVILEGES. IN ADDITION TO THE EX-OFFICIO BOARD POSITIONS, THE BOARD OF DIRECTORS SHALL INCLUDE TWO MEMBERS OF FRANCISCAN SISTERS OF CHRISTIAN CHARITY, EIGHT TO TEN INDEPENDENT MEMBERS FROM THE COMMUNITIES SERVED BY THE CORPORATION, AND TWO OTHERS APPOINTED BY BFHFM, LLC. BFHFM, LLC. HAS THE RIGHT TO APPOINT THE INDEPENDENT COMMUNITY BOARD MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7B | BFHFM, LLC, WHICH IS 100% OWNED BY FROEDTERT HEALTH, INC., AS THE MAJORITY CORPORATE MEMBER OF HFM, HAS CERTAIN POWERS AND AUTHORITIES WITH RESPECT TO THE OPERATIONS AND MANAGEMENT OF HFM AS SET FORTH IN THE HFM BYLAWS. IN ADDITION, BFHFM, LLC AND FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC JOINTLY EXERCISE CERTAIN RETAINED AUTHORITIES AS DEFINED IN HFM'S BYLAWS. |
| FORM 990, PART VI, SECTION B, LINE 11B | FROEDTERT HEALTH, INC. ACCOUNTING STAFF PREPARE FORM 990 WHICH IS REVIEWED BY FROEDTERT HEALTH, INC.'S FINANCIAL LEADERS. THE 990 IS THEN REVIEWED BY KPMG, FROEDTERT HEALTH INC.'S OUTSIDE ACCOUNTING FIRM. NEXT, THE 990 IS PROVIDED TO THE FROEDTERT HEALTH INC. AUDIT COMMITTEE AND BOARD OF DIRECTORS. AND FINALLY, THE 990 IS FILED AS REQUIRED. |
| FORM 990, PART VI, SECTION B, LINE 12C | ON AN ANNUAL BASIS ALL OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE DATA IS COMPILED, AND THE FH VICE PRESIDENT-CHIEF COMPLIANCE OFFICER (CCO), THE SENIOR VICE-PRESIDENT-GENERAL COUNSEL AND/OR DELEGATE WILL REVIEW ALL FORMS AND NOTIFICATIONS TO DETERMINE IF ANY CONFLICTS OF INTEREST EXIST IN THE DISCLOSURE DOCUMENTS. IF IT IS DETERMINED THAT A CONFLICTS OF INTEREST EXISTS, THEN THE PERSON MAKING THE DISCLOSURE SHALL BE RELIEVED OF HIS/HER OBLIGATIONS ON BEHALF OF HFM WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT THAT CREATES THE CONFLICT OF INTEREST. A REPORT OF ALL CONFLICTS OF INTEREST WILL BE MADE BY THE CCO AT LEAST ANNUALLY TO THE FH FINANCE COMMITTEE OF THE FH BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION REVIEW AND APPROVAL PROCESS CEO AND TOP MANAGEMENT: IN ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S CEO AND TOP MANAGEMENT, INDEPENDENT COMPENSATION CONSULTANTS ARE UTILIZED. COMPENSATION STUDIES ARE COMPLETED TO GATHER COMPARATIVE DATA. PERSONS WITH A CONFLICT OF INTEREST REGARDING THE COMPENSATION ARRANGEMENTS AT ISSUE ARE NOT INVOLVED IN THE DECISION MAKING PROCESS, AND AMOUNTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. IN ADDITION, THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING FOR DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. COMPENSATION REVIEW AND APPROVAL PROCESS OFFICERS AND KEY EMPLOYEES: IN ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S OFFICERS, INDEPENDENT COMPENSATION CONSULTANTS ARE UTILIZED. COMPENSATION STUDIES ARE COMPLETED TO GATHER COMPARATIVE DATA. PERSONS WITH A CONFLICT OF INTEREST REGARDING THE COMPENSATION ARRANGEMENTS AT ISSUE ARE NOT INVOLVED IN THE DECISION MAKING PROCESS, AND AMOUNTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF FROEDTERT HEALTH, INC. (A RELATED ORGANIZATION) IN ADDITION, THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING FOR DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. |
| FORM 990, PART VI, SECTION C, LINE 19 | DISCLOSURE: FROEDTERT HEALTH, INC'S QUARTERLY FINANCIAL INFORMATON IS MADE AVAILABLE TO THE PUBLIC ONLINE THROUGH THE DIGITAL ASSURANCE CORPORATION, INC. WEBSITE. ANYONE CAN REGISTER TO RECEIVE ONGOING ACCESS TO AND NOTIFICATIONS REGARDING FINANCIAL STATEMENTS AT THE ONLINE WEBSITE. ADDITIONALLY, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE CORPORATE OFFICE UPON REQUEST. |
| FORM 990, PART VII, SECTION A | ON MARCH 1, 2021, FROEDTERT HEALTH INC. BECAME THE COMMON LAW EMPLOYER OF HOLY FAMILY MEMORIAL. THEREFORE, PART VII, SECTION A COLUMN D SHOWS REPORTABLE COMPENSATION PAID BY THE ORGANIZATION FOR THE TIME PERIOD 1/1/2021 - 2/28/2021 FOR THE APPLICABLE INDIVIDUAL AND PART VII, SECTION A COLUMN E SHOWS REPORTABLE COMPENSATION PAID BY FROEDTERT HEALTH, THE COMMON LAW EMPLOYER FOR THE TIME PERIOD 3/1/2021 - 12/31/2021. THE TOTAL OF COLUMNS D AND COLUMNS E TIE TO BOX 5 OF THE 2021 W-2 FOR EACH INDIVIDUAL LISTED. MARK BEHL, STEVEN LITTLE AND JEFFREY VAN DE KREEKE WERE EMPLOYEES OF FROEDTERT HEALTH FOR ALL OF TAX YEAR 2021. PART VII, SECTION A, COLUMN (E) AND SCHEDULE J, PART II, COLUMNS (B)(I)-(III) REFLECT THE COMPENSATION FOR THESE EMPLOYEES FOR ALL OF 2021 THAT TIES TO THEIR 2021 W-2S EVEN THOUGH THEY WERE ONLY OFFICERS OF THE FILING ORGANIZATION FROM 3/1/2021 - 12/31/2021. |
| FORM 990, PART IX, LINE 11G | GENERAL SERVICES: PROGRAM SERVICE EXPENSES 3,032,030. MANAGEMENT AND GENERAL EXPENSES 10,924,954. FUNDRAISING EXPENSES 148. TOTAL EXPENSES 13,957,132. STAFFING SERVICES: PROGRAM SERVICE EXPENSES 8,833,104. MANAGEMENT AND GENERAL EXPENSES 3,516,760. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,349,864. REPAIR & MAINTENANCE SERVICES: PROGRAM SERVICE EXPENSES 2,348,209. MANAGEMENT AND GENERAL EXPENSES 827,189. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,175,398. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 163,430. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 163,430. CONSULTING FEES: PROGRAM SERVICE EXPENSES 22,407. MANAGEMENT AND GENERAL EXPENSES 136,638. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 159,045. LANDSCAPE & GROUNDS SERVICES: PROGRAM SERVICE EXPENSES 74,954. MANAGEMENT AND GENERAL EXPENSES 57,469. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 132,423. |
| FORM 990, PART XI, LINE 9: | CONTRIBUTED CAPITAL 32,500,000. INVESTMENT RETURN ON RESTRICTED ASSETS -481,467. OTHER CHANGES TO RESTRICTED NET ASSETS 5,813. ADJUSTMENTS TO FIXED ASSETS 677,789. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FROEDTERT MANITOWOC MEDICAL GROUP LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9200 W WISCONSIN AVE | AddressLine1Txt |
| City | MILWAUKEE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53226 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 871785388 | EIN |
| Primary Activities | HLTHCARE SVCS | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Total Income | $5,075,524 | TotalIncomeAmt |
| End Of Year Assets | $3,488,380 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HFM INC | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| FROEDTERT HEALTH INC | |||||||||||
| 9200 W WISCONSIN AVE | MILWAUKEE | WI | 53226 | 392014409 | MGMT SVCS | WI | 501(C)3 | 12 TYPE III | N/A | 0 | |
| ST JOSEPH'S COMMUNITY HOSP OF WEST BEND | |||||||||||
| 3200 PLEASANT VALLEY RD | WEST BEND | WI | 53095 | 390806302 | HOSPITAL | WI | 501(C)3 | 3 | 0 | FH INC | |
| ST JOSEPH'S COMMUNITY FOUNDATION INC | |||||||||||
| 3200 PLEASANT VALLEY RD | WEST BEND | WI | 53095 | 392034296 | HLTH/WELFARE | WI | 501(C)3 | LN 7 | 0 | SJH | |
| COMMUNITY MEMORIAL HOSPITAL OF MF | |||||||||||
| W180 N8085 TOWN HALL RD | MENOMONEE FALLS | WI | 53051 | 390987025 | HOSPITAL | WI | 501(C)3 | 3 | 0 | FH INC | |
| FROEDTERT MEMORIAL LUTHERAN HOSPITAL | |||||||||||
| 9200 W WISCONSIN AVE | MILWAUKEE | WI | 53226 | 396105970 | HOSPITAL | WI | 501(C)3 | 3 | 0 | FH INC | |
| QHS 1 INC | |||||||||||
| 9200 W WISCONSIN AVE | MILWAUKEE | WI | 53226 | 202636686 | HLTHCARE SVCS | WI | 501(C)3 | 12 TYPE III | 0 | FH INC | |
| COMMUNITY MEMORIAL FOUNDATION OF MF | |||||||||||
| W180 N8085 TOWN HALL RD | MENOMONEE FALLS | WI | 53051 | 391635057 | HLTH/WELFARE | WI | 501(C)3 | LN 10 | 0 | CMH | |
| COMMUNITY OUTPATIENT HEALTH SERVICES | |||||||||||
| W180 N8085 TOWN HALL RD | MENOMONEE FALLS | WI | 53051 | 391743056 | MED/DENT SVCS | WI | 501(C)3 | 3 | 0 | CMH | |
| FROEDTERT HOSPITAL FOUNDATION INC | |||||||||||
| 9200 W WISCONSIN AVE | MILWAUKEE | WI | 53226 | 391431192 | HLTH/WELFARE | WI | 501(C)3 | LN 7 | 0 | FMLH | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| FMLH MCW REAL ESTATE VENTURES LLC | ||||||||||
| 9200 W WISCONSIN AVE | MILWAUKEE | WI | 53226 | 260629591 | REAL ESTATE | WI | N/A | N/A | 0 | 0 |
| WISCONSIN DIAGNOSTIC LABORATORIES LLC | ||||||||||
| 9200 W WISCONSIN AVE | MILWAUKEE | WI | 53226 | 391896819 | LAB SERVICES | WI | N/A | N/A | 0 | 0 |
| D1 SPORTS TRAINING OF MILWAUKEE LLC | ||||||||||
| 9200 W WISCONSIN AVE | MILWAUKEE | WI | 53226 | 473322294 | SPORTS MEDICINE | WI | N/A | N/A | 0 | 0 |
| DREXEL TOWN SQUARE SURGERY CENTER LLC | ||||||||||
| 7901 S 6TH ST | OAK CREEK | WI | 53154 | 814904300 | SURGERY CENTER | WI | N/A | N/A | 0 | 0 |
| FROEDTERT SURGERY CENTER LLC | ||||||||||
| 9200 W WISCONSIN AVE | MILWAUKEE | WI | 53226 | 201499345 | SURGERY CENTER | WI | N/A | N/A | 0 | 0 |
| MENOMONEE FALLS AMBULATORY SURGERY CTR | ||||||||||
| W180 N8045 TOWN HALL RD | MENOMONEE FALLS | WI | 53051 | 391745697 | SURGERY CENTER | WI | N/A | N/A | 0 | 0 |
| THP-FROEDTERT HEALTH VENTURES LLC | ||||||||||
| 1415 LOUISIANA ST | HOUSTON | TX | 77002 | 823559342 | HEALTH CARE | TX | N/A | N/A | 0 | 0 |
| FROEDTERT & THE MCW NETWORK LLC | ||||||||||
| 9200 W WISCONSIN AVE | MILWAUKEE | WI | 53226 | 814382585 | HEALTH CARE | WI | N/A | N/A | 0 | 0 |
| FROEDTERT & MEDICAL COLLEGE OF WI ACO | ||||||||||
| 8710 WATERTOWN PLANK RD | MILWAUKEE | WI | 53226 | 833159534 | HEALTH CARE | WI | N/A | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HART'S MILLS INSURANCE COMPANY SPC | |||||||||||||||||
| 62 FORUM LANE 3RD FLOOR | GRAND CAYMAN | CJ | 981311808 | SELF-INSURANCE | CJ | N/A | C | 0 | |||||||||
| HOLY FAMILY HEALTH SERVICES INC | |||||||||||||||||
| 391572253 | HEALTH SERVICES | C | Yes (1) | 1650 S 41ST ST | MANITOWOC | WI | 54220 | WI | HFM | $398,675 | $2,094,146 | 1.00000 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| HOLY FAMILY HEALTH SERVICES | ||
| Q | $788,409 | FMV |
| HOLY FAMILY HEALTH SERVICES | ||
| P | $52,083 | FMV |