DICKINSON COUNTY HEALTHCARE SYSTEM: Form 990, tax year 2022
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- Organization
- DICKINSON COUNTY HEALTHCARE SYSTEM (EIN 38-2780429)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-13
- IRS object ID
- 202333179349302143
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-13T09:31:46-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10 S RIVERSIDE PLAZA 9TH FLOOR | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382780429 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DICKINSON COUNTY HEALTHCARE SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DICK | BusinessNameControlTxt |
| Phone | 7153875511 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1721 SOUTH STEPHENSON AVENUE | AddressLine1Txt |
| City | IRON MOUNTAIN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49801 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CATHY BUKOWSKI | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7153875511 | PhoneNum |
| Signature | 2023-11-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | CATHY | PersonFirstNm |
| Person Last | BUKOWSKI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LOWENTHAL | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 3122071040 | PhoneNum |
| Preparation | 2023-11-08 | 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 | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARSHFIELD MEDICAL CENTER-DICKINSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SUSAN TURNEY MD CEO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 N OAK AVENUE | AddressLine1Txt |
| City | MARSHFIELD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54449 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $127,935,607 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.DCHS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1990 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | WE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 831 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $1,801,176 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $118,204,998 | CYProgramServiceRevenueAmt |
| CY Investment Income | $5,003,367 | CYInvestmentIncomeAmt |
| CY Other Revenue | $2,186,854 | CYOtherRevenueAmt |
| CY Total Revenue | $127,196,395 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $55,864,389 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $66,781,131 | CYOtherExpensesAmt |
| CY Total Expenses | $122,645,520 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | $4,550,875 | CYRevenuesLessExpensesAmt |
| Total Assets EOY | $80,915,306 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $57,151,834 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances EOY | $23,763,472 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $117,107,885 | ExpenseAmt |
| Revenue | $118,204,998 | RevenueAmt |
| Desc | DICKINSON COUNTY HEALTHCARE SYSTEM (DCHS) INCLUDES A 49-BED, GENERAL MEDICAL AND SURGICAL HOSPITAL LOCATED IN IRON MOUNTAIN, MICHIGAN AND PRIMARY CARE CLINICS IN IRON MOUNTAIN, KINGSFORD AND NORWAY, MICHIGAN AND FLORENCE, WISCONSIN. DCHS SERVES COMMUNITIES IN MICHIGAN'S CENTRAL UPPER PENINSULA AND NORTHERN WISCONSIN BY PROVIDING A BROAD RANGE OF HIGH QUALITY ACUTE CARE INCLUDING INPATIENT, OUTPATIENT, DIAGNOSTIC, AND SPECIALTY SERVICES. | Desc |
| Total Program Service Expenses | $117,107,885 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | 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 | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 79 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 831 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | 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 | 0 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JANETTE TOWNSEND VP OF FINANCE | PersonNm |
| Phone | 7153875511 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 N OAK AVENUE | AddressLine1Txt |
| City | MARSHFIELD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54449 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| MARK BUGHER | |||||||||
| CHAIR | 1.00 | 9.00 | Yes (X) | Yes (X) | $0 | $26,500 | $0 | ||
| MARK BRADLEY | |||||||||
| VICE CHAIR | 1.00 | 5.00 | Yes (X) | Yes (X) | $0 | $9,500 | $0 | ||
| RUWAN DISSANAYAKE MD | |||||||||
| SECRETARY | 1.00 | 50.00 | Yes (X) | Yes (X) | $0 | $528,556 | $54,315 | ||
| JOHN BALTUS | |||||||||
| TREASURER | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DOUG MATHISON | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SUSAN TURNEY MD | |||||||||
| BOARD MEMBER/MCHS CEO | 1.00 | 54.00 | Yes (X) | $0 | $3,048,492 | $315,344 | |||
| COLLEEN HOERNEMAN | |||||||||
| BOARD MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $7,500 | $0 | |||
| WILLIAM MELMS MD | |||||||||
| BOARD MEMBER/MCHS CMO | 1.00 | 54.00 | Yes (X) | $0 | $829,413 | $57,055 | |||
| MARGARET MINERICK | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $1,000 | $0 | $0 | |||
| GORDON EDWARDS | |||||||||
| MCHS CFO/COO - PART YEAR | 1.00 | 54.00 | Yes (X) | $0 | $829,645 | $31,752 | |||
| KATHY BRESSLER | |||||||||
| MCHS COO | 1.00 | 54.00 | Yes (X) | $0 | $370,779 | $16,874 | |||
| JERARD JENSEN | |||||||||
| MCHS GENERAL COUNSEL | 1.00 | 54.00 | $0 | $1,058,880 | $65,255 | Yes (X) | |||
| ADINA-MARIA ANDERSON DPM | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $480,836 | $0 | $17,050 | Yes (X) | |||
| MARYAM HAMIDI MD | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $666,731 | $0 | $9,016 | Yes (X) | |||
| ERIC JOHNSON MD | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $572,085 | $0 | $17,729 | Yes (X) | |||
| ADAM RYAN MD | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $478,644 | $0 | $6,611 | Yes (X) | |||
| SARAH VENDITTI MD | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $840,539 | $0 | $15,932 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,039,835 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,709,265 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $606,933 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 81 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | 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 |
|---|---|---|---|---|---|
| UP REHAB SERVICES LLC | |||||
| 841 W WASHINGTON STREET SUITE 500 | MARQUETTE | MI | 49855 | MEDICAL SERVICES | $3,130,232 |
| SUMMIT SURGICAL & ENDOSCOPY SERVICES | |||||
| 1711 S STEPHENSON AVENUE SUITE 305 | IRON MOUNTAIN | MI | 49801 | MEDICAL SERVICES | $1,790,316 |
| MEDICAL SOLUTIONS LLC | |||||
| PO BOX 850737 | MINNEAPOLIS | MN | 55489 | MEDICAL SERVICES | $958,874 |
| CLAYTON M SHAKER MD PC | |||||
| N3575 WILLIAMS DRIVE | IRON MOUNTAIN | MI | 49801 | MEDICAL SERVICES | $621,595 |
| MELISSA KOENIG | |||||
| 575 S OGDEN ST | DENVER | CO | 80209 | MEDICAL SERVICES | $230,250 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,799,838 | GovernmentGrantsAmt |
| All Other Contributions | $1,338 | AllOtherContributionsAmt |
| Total Contributions | $1,801,176 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $107,829,753 | $107,829,753 |
| MISC OTHER OPERATING REVENUE | 621110 | $9,269,506 | $9,269,506 |
| INTERCOMPANY REVENUE | 621110 | $1,105,739 | $1,105,739 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $118,204,998 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,498,724 | TotalRevenueColumnAmt |
| Exclusion | $4,498,724 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,186,854 | 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 | $2,186,854 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,186,854 | TotalRevenueColumnAmt |
| Exclusion | $2,186,854 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,243,855 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $739,212 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $504,643 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $504,643 | TotalRevenueColumnAmt |
| Exclusion | $504,643 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $127,196,395 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $118,204,998 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $7,190,221 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000 | TotalAmt |
| Management And General | $1,000 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,154,275 | TotalAmt |
| Program Services | $42,489,363 | ProgramServicesAmt |
| Management And General | $2,664,912 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,404,676 | TotalAmt |
| Program Services | $1,404,676 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,312,550 | TotalAmt |
| Program Services | $5,601,314 | ProgramServicesAmt |
| Management And General | $711,236 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,991,888 | TotalAmt |
| Program Services | $2,991,888 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,538 | TotalAmt |
| Management And General | $131,538 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,931 | TotalAmt |
| Management And General | $96,931 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,833,511 | TotalAmt |
| Program Services | $23,077,924 | ProgramServicesAmt |
| Management And General | $755,587 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $347,439 | TotalAmt |
| Program Services | $347,439 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $708,051 | TotalAmt |
| Program Services | $668,123 | ProgramServicesAmt |
| Management And General | $39,928 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,777,012 | TotalAmt |
| Program Services | $1,777,012 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,845,795 | TotalAmt |
| Program Services | $1,825,317 | ProgramServicesAmt |
| Management And General | $20,478 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $266,162 | TotalAmt |
| Program Services | $249,067 | ProgramServicesAmt |
| Management And General | $17,095 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $678,116 | TotalAmt |
| Program Services | $678,116 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,311,446 | TotalAmt |
| Program Services | $5,311,446 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $688,620 | TotalAmt |
| Program Services | $688,620 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $25,645,827 | $25,645,009 | $818 |
| BAD DEBT EXPENSE | $2,953,029 | $2,953,029 | |
| DUES, SUBSCRIPTIONS, LI | $2,114,206 | $1,017,848 | $1,096,358 |
| EQUIP. REPAIRS & MAINT. | $293,211 | $291,457 | $1,754 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,237 | TotalAmt |
| Program Services | $90,237 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,645,520 | TotalAmt |
| Program Services | $117,107,885 | ProgramServicesAmt |
| Management And General | $5,537,635 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $12,813,353 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $520,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $21,583,137 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,985,634 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,460,030 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $41,453,395 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,720,858 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $36,732,537 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $882,581 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,036,676 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,901,358 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $80,915,306 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $14,279,077 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $101,014 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,861,386 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $39,449,484 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,460,873 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $57,151,834 | 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 | $0 | BOYAmt |
| EOY | $23,763,472 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $23,763,472 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $80,915,306 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,550,875 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $207,101 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $19,005,496 | OtherChangesInNetAssetsAmt |
| 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,076,700 | OtherCostOrOtherBasisAmt |
| Book Value | $3,076,700 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,936,601 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,011,929 | DepreciationAmt |
| Book Value | $21,924,672 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,927,624 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,614,976 | DepreciationAmt |
| Book Value | $11,312,648 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $512,470 | OtherCostOrOtherBasisAmt |
| Depreciation | $93,953 | DepreciationAmt |
| Book Value | $418,517 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $36,732,537 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| CAPITAL LEASES PAYABLE | $1,065,745 |
| RESERVE MALPRACTICE CLAIMS | $50,000 |
| LT OPERATING LEASE PAYABLE | $345,128 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,460,873 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION APPLIES FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES (ASC 740), WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC 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 740, TAX POSITIONS WILL BE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND WILL PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. THE SYSTEM HAS DETERMINED THAT IT DOESN'T HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2022 OR DECEMBER 31, 2021. | ExplanationTxt |
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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,002 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,002 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,480,267 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,373,704 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,106,563 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05940 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,482,269 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,373,704 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,108,565 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05940 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $321,581 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,500 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $319,081 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,676 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,676 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,223 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,223 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $328,480 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,500 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $325,980 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,810,749 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,376,204 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,434,545 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06210 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,399 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,399 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,276 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,276 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,675 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $16,675 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $920,754 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $23,201,447 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $27,477,890 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$4,276,443 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | 0 | FinancialAssistancePrvsnInd |
| 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 | MARSHFIELD MEDICAL CENTER - DICKINSON | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1721 SOUTH STEPHENSON AVENUE | AddressLine1Txt |
| City | IRON MOUNTAIN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | MARSHFIELD MEDICAL CENTER - DICKINSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (1) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | 0 | CHNAConductedInd |
| 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.DCHS.ORG/FINANCIAL-ASSISTANCE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.DCHS.ORG/FINANCIAL-ASSISTANCE/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.DCHS.ORG/FINANCIAL-ASSISTANCE/ | 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 |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | MARSHFIELD MEDICAL CENTER - DICKINSON | FormAndLineReferenceDesc |
| Explanation | PART V, SECTION B, LINE 2: EFFECTIVE FEBRUARY 1, 2022, DICKINSON COUNTY HEALTHCARE SYSTEM (DCHS), JOINED MARSHFIELD CLINIC HEALTH SYSTEM, INC. (MCHS) AND ITS SUBSIDIARIES WITH THE CLOSING OF AN AFFILIATION AGREEMENT. MCHS HOSPITALS, INC., A SUBSIDIARY OF MCHS, BECAME THE SOLE MEMBER OF DCHS THROUGH A MEMBER SUBSTITUTION. | ExplanationTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 16 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - MMC-DICKINSON BARK RIVER CENTER | ||||
| 2845 US RTE 2 | BARK RIVER | MI | 49807 | CARDIOLOGY AND DIAGNOSTIC SERVICES |
| 2 - MMC-DICKINSON FAMILY MEDICINE | ||||
| 1711 S STEPHENSON AVE SUITE 125 | IRON MOUNTAIN | MI | 49801 | FAMILY PRACTICE |
| 3 - MMC-DICKINSON NORWAY FAMILY MED | ||||
| N1667 US-8 | NORWAY | MI | 49870 | FAMILY PRACTICE |
| 4 - MMC-DICKINSON NORWAY FAM & GERIATRIC CEN | ||||
| 500 MAIN ST | NORWAY | MI | 49870 | FAMILY PRACTICE & GERIATIC |
| 5 - MMC-DICKINSON HEMATOLOGY ONCOLOGY | ||||
| 1711 S STEPHENSON AVENUE SUITE 315 | IRON MOUNTAIN | MI | 49801 | HEMATOLOGY/ONCOLOGY CLINIC |
| 6 - MMC-DICKINSON INT MEDICINE & NEPHROLOGY | ||||
| 1711 S STEPHENSON AVE SUITE 225 | IRON MOUNTAIN | MI | 49801 | INTERNAL MEDICINE/NEPHROLOGY |
| 7 - MMC-DICKINSON OBSTETRICS & GYNECOLOGY | ||||
| 1721 S STEPHENSON AVENUE | IRON MOUNTAIN | MI | 49801 | OB/GYN |
| 8 - MMC-DICKINSON ORTHOPEDICS | ||||
| 1711 S STEPHENSON AVE SUITE 100 | IRON MOUNTAIN | MI | 49801 | ORTHOPEDIC PRACTICE |
| 9 - MMC-DICKINSON PODIATRY SERVICES | ||||
| 225 WEST H STREET | IRON MOUNTAIN | MI | 49801 | PODIATRY SERVICES |
| 10 - MMC-DICKINSON PRIMARY CARE | ||||
| 1711 S STEPHENSON AVE SUITE 210 | IRON MOUNTAIN | MI | 49801 | PRIMARY CARE |
| 11 - MMC-DICKINSON SURGERY AND ENDOSCOPY | ||||
| 1711 S STEPHENSON AVE SUITE 305 | IRON MOUNTAIN | MI | 49801 | SURGERY & ENDOSCOPY |
| 12 - MMC-DICKINSON UROLOGY | ||||
| 1711 S STEPHENSON AVENUE SUITE 320 | IRON MOUNTAIN | MI | 49801 | UROLOGY SERVICES |
| 13 - MMC-DICKINSON FLORENCE CENTER | ||||
| 1010 OLIVE AVE | FLORENCE | WI | 54121 | FAMILY CLINIC |
| 14 - MMC-DICKINSON REGIONAL HEART CARE CLINIC | ||||
| 1711 S STEPHENSON AVENUE SUITE 315 | IRON MOUNTAIN | MI | 49801 | HEART CARE |
| 15 - MMC-DICKINSON SLEEP MEDICINE CENTER | ||||
| 1100 S CARPENTER AVENUE | KINGSFORD | MI | 49802 | SLEEP DISORDER |
| 16 - MMC-DICKINSON WOUND HEAL&HYPERBARIC MED | ||||
| 1707 S STEPHENSON AVE | IRON MOUNTAIN | MI | 49801 | WOUND CARE/HYPERBARIC |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE: AMOUNTS CALCULATED IN PART I, LINE 7 ARE DETERMINED BASED ON A COST-TO-CHARGE RATIO. OTHER BENEFITS ARE DETERMINED BASED ON THE DIRECT AND INDIRECT COSTS (WHERE ALLOCATED) ASSOCIATED WITH A PROGRAM NET OF EARNED REVENUE. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | MARSHFIELD MEDICAL CENTER- DICKINSON:IN ALIGNMENT WITH THE MARSHFIELD CLINIC HEALTH SYSTEM MISSION STATEMENT, WE ENRICH LIVES, BY PARTICIPATING IN VARIOUS COMMUNITY-BUILDING ACTIVITIES TO IMPROVE THE HEALTH OF THE COMMUNITY, AND BY ADDRESSING SOCIAL DETERMINANTS OF HEALTH AND HEALTH INEQUITIES. DUE TO LINGERING IMPACTS OF COVID-19, DECREASED STAFFING AND CAPACITY, MANY COMMUNITY-BUILDING ACTIVITIES REMAINED LIMITED DURING THIS REPORTING PERIOD. SOME EXAMPLES OF COMMUNITY BUILDING ACTIVITIES INCLUDED: COALITION BUILDING: MARSHFIELD MEDICAL CENTER-DICKINSON STAFF PARTICIPATED IN COMMUNITY COALITIONS AND COLLABORATIONS WITH THE PURPOSE OF IMPROVING THE HEALTH OF THE COMMUNITY BY ADDRESSING MENTAL/BEHAVIORAL HEALTH, ALCOHOL AND OTHER DRUGS ABUSE, AND HEALTHY LIVING. THESE COMMUNITY GROUPS INCLUDED THE DICKINSON-IRON COUNTY COLLABORATIVE, DICKINSON-IRON GREAT START COLLABORATIVE, COMMUNITIES THAT CARE, FLORENCE COUNTY AODA/MENTAL HEALTH TASK FORCE, CHILD ADVOCACY AND CHILD ABUSE PREVENTION NETWORK, AND LOCAL CHAPTER OF THE ROTARY CLUB.WORKFORCE DEVELOPMENT: MARSHFIELD MEDICAL CENTER-DICKINSON COLLABORATED WITH AREA HIGH SCHOOLS TO OFFER PROGRAMS FOR HIGH SCHOOL STUDENTS INTERESTED IN MEDICAL CAREERS, AND OBSERVATIONAL JOB EXPERIENCES FOR HIGH SCHOOL GRADUATES. HOSPITAL STAFF WERE INVITED TO HEALTH OCCUPATIONS CLASS OFFERED AT THE DICKINSON-IRON TECH SCHOOL TO EDUCATE AND SHARE INFORMATION ABOUT HEALTH PROFESSIONS WITH HIGH SCHOOL STUDENTS. MMC-DICKINSON FUNCTIONED AS A CLINICAL SITE FOR STUDENT NURSES, RESPIRATORY THERAPY, MEDICAL ASSISTANTS, LAB, AND IMAGING. ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS AND SAFETY: MARSHFIELD MEDICAL CENTER-DICKINSON HAS ALWAYS PRIORITIZED FINANCIALLY SUPPORTING SWIM LESSONS FOR ALL THIRD GRADE STUDENTS FOR THE SURROUNDING SCHOOLS. STUDENTS FROM WOODLAND ELEMENTARY, NORTH ELEMENTARY, NORWAY ELEMENTARY, BISHOP BARAGA ELEMENTARY, HOLY SPIRIT ELEMENTARY, NORTH DICKINSON ELEMENTARY, NIAGARA ELEMENTARY, AND FLORENCE ELEMENTARY ATTEND. EACH CLASS RECEIVED FIVE 40-MINUTE LESSONS AT THE LOCAL YMCA. NEARLY 500 CHILDREN PARTICIPATE EACH YEAR. HAVING ONE OF ONLY A FEW CERTIFIED SANE NURSES IN THE REGION, MMC-DICKINSON HAS PROVIDED EDUCATION AND ADVOCACY ON ISSUES SUCH AS HUMAN TRAFFICKING, DOMESTIC VIOLENCE, CHILD SAFETY, AND MANDATORY REPORTING. LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS: PREVIOUS MMC-DICKINSON PRESIDENT, CHUCK NELSON, PROVIDED A PRESENTATION AT A LEADERSHIP CONFERENCE AT BAY COLLEGE. ECONOMIC DEVELOPMENT: HOSPITAL STAFF INCLUDING MANAGEMENT PARTICIPATED IN THE DICKINSON CHAMBER OF COMMERCE AND DICKINSON AREA ECONOMIC DEVELOPMENT ALLIANCE. MMC-DICKINSON HAS BEEN VERY SUPPORTIVE OF DICKINSON AREA ECONOMIC DEVELOPMENT ALLIANCE'S SMALL BUSINESS RETENTION & GROWTH COMMITTEE. THE COMMITTEE HAS CREATED AN INITIATIVE CALLED LOYAL TO LOCAL. LOYAL TO LOCAL HAS IS A CAMPAIGN TO RAISE AWARENESS OF THE IMPACT OF SMALL BUSINESSES ON OUR COMMUNITY AND ENCOURAGES CUSTOMERS TO SUPPORT LOCAL BUSINESSES BEFORE ORDERING ONLINE OR GOING OUTSIDE THE AREA FOR SERVICES AND ITEMS. COMMUNITY SUPPORT: MARSHFIELD MEDICAL CENTER-DICKINSON STAFF PARTICIPATED ACTIVELY ON SEVERAL LOCAL ORGANIZATIONS SUCH AS THE EMERGENCY OPERATIONS COMMITTEE AND INSTANT COMMAND GROUP, LOCAL EMERGENCY PLANNING COMMITTEE, AND DICKINSON CHAMBER OF COMMERCE. STAFF INCLUDING MANAGEMENT ARE INVOLVED IN PLANNING, COORDINATING, AND IMPLEMENTING VARIOUS COLLABORATIVE EFFORTS AND INITIATIVES IN THE COMMUNITY. ADDITIONALLY, MMC-DICKINSON STAFF PROVIDE ATHLETIC TRAINING SUPPORTS TO A NUMBER OF SCHOOL DISTRICTS WITHIN THE COUNTY AT VARIOUS SPORTING EVENTS YEAR ROUND. MMC-DICKINSON PARTICIPATES IN A COLLABORATIVE EFFORT WITH OTHER AREA HOSPITALS TO PROVIDE BLOOD DRIVES TO SUPPLY THE REGIONAL BLOOD BANK WITH BLOOD PRODUCTS. |
| PART III, LINE 2: | BAD DEBT EXPENSE IS REPORTED AT COST USING A COST-TO-CHARGE RATIO. |
| PART III, LINE 3: | NO BAD DEBT IS ESTIMATED TO RELATE TO CHARITY CARE. |
| PART III, LINE 4: | PATIENT ACCOUNTS RECEIVABLE ARE REDUCED FOR EXPLICIT PRICE CONCESSIONS AND BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AS AN IMPLICIT PRICE CONCESSION. IN EVALUATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND CONTRACTUAL TERMS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ADDITIONAL IMPLICIT DISCOUNT, IF NECESSARY (I.E., FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND CO-PAYMENTS 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 AND PATIENTS WITH DEDUCTIBLES AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS AN IMPLICIT DISCOUNT IN THE PERIOD OF SERVICE ON 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. THE SYSTEM'S IMPLICIT ALLOWANCE FOR SELF-PAY PATIENTS WAS APPROXIMATELY 61% AND 60% OF SELF-PAY ACCOUNTS RECEIVABLE AS OF DECEMBER 31, 2022 AND DECEMBER 31, 2021, RESPECTIVELY. |
| PART III, LINE 8: | THE ALLOWABLE MEDICARE COST ON PART III, LINE 6 IS DETERMINED USING THE CY 2022 MEDICARE COST REPORT. THE REIMBURSEMENT FROM MEDICARE IS DEDUCTED FROM THE ESTIMATED COST USING A COST-TO CHARGE RATIO IN ORDER TO DETERMINE THE SHORTFALL FROM THE MEDICARE PROGRAM. THE SYSTEM TREATS MEDICARE SHORTFALL AS COMMUNITY BENEFIT. THE REASONS FOR THIS TREATMENT INCLUDE (1) NON-NEGOTIABLE MEDICARE RATES ARE SOMETIMES NOT ALIGNED WITH THE TRUE COSTS OF TREATING MEDICARE PATIENTS; (2) THE SYSTEM IS ALLEVIATING THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES; AND (3) IRS REV. RUL. 69-545 NOTES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THIS ACTION INDICATES THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. |
| PART VI, LINE 2: | ALL MARSHFIELD MEDICAL CENTER FACILITIES ASSESSED THE HEALTH CARE NEEDS OF THE COMMUNITIES THEY SERVE BY CONDUCTING STANDARD CHNA PRACTICES, INCLUDING: -REVIEW OF COMMUNITY PARTNERS' REPORTS (I.E. UNITED WAY) -REVIEW OF PUBLICLY AVAILABLE COMMUNITY HEALTH DATA (I.E. COUNTY HEALTH RANKINGS) -COMPLETION OF KEY INFORMANT INTERVIEWS WITH COMMUNITY LEADERS ABOUT THE COMMUNITY'S HEALTH NEEDS -COMPLETION OF COMMUNITY CONVERSATIONS WITH COMMUNITY MEMBERS -PARTICIPATION IN COMMUNITY HEALTH COMMITTEES AND BOARDS |
| PART VI, LINE 3: | FINANCIAL COUNSELORS ASSIST INDIVIDUALS WITH IDENTIFYING, REFERRING AND/OR APPLYING FOR PUBLIC, PRIVATE OR CHARITABLE RESOURCES FOR WHICH THE PATIENT MAY QUALIFY. COUNSELORS ARE AVAILABLE VIA PHONE AND IN PERSON TO ASSIST INDIVIDUALS WITH FINANCIAL ASSISTANCE.UNCOMPENSATED CARE PACKETS ARE GIVEN TO PATIENTS IN EVERY CLINIC AND DEPARTMENT OF THE FACILITY WHERE A PATIENT IS UNINSURED, INQUIRES ABOUT ASSISTANCE OR EXPRESSES HARDSHIP. COPIES OF THESE DOCUMENTS ARE ALSO AVAILABLE IN THE LOBBIES OF ALL CLINICS AND DEPARTMENTS OF THE FACILITY IN BROCHURE STANDS AS WELL AS POSTED IN EXAM ROOMS. THEY ARE ALSO GIVEN TO ALL INPATIENTS WITH THEIR INPATIENT ADMISSION PAPERWORK TO OFFER SUPPORT IF NEEDED OR QUESTIONS. |
| PART VI, LINE 4: | MARSHFIELD MEDICAL CENTER-DICKINSON (MMC-DICKINSON) SERVICE AREA IS NOT DEFINED BY COUNTY BORDERS BUT SERVES THOSE IN HIGH NEED AREAS WITH LIMITED RESOURCES. MMC-DICKINSON FOCUSES ON SERVING THOSE THAT ARE UNDERSERVED AND LIVING IN RURAL AREAS OF THE SERVICE AREA. DICKINSON COUNTY IS IN THE CENTRAL UPPER PENINSULA OF MICHIGAN BORDERING WISCONSIN. THE COUNTY IS COMPRISED OF THREE CITIES (IRON MOUNTAIN, KINGSFORD, AND NORWAY) AND SEVEN TOWNSHIPS (BREEN, BREITUNG, FELCH, NORWAY, SAGOLA, WAUCEDAH, AND WEST BRANCH) SPANNING OVER A TOTAL OF 777 SQUARE MILES. IN 2021, DICKINSON COUNTY HAS A POPULATION TOTALING 25,787. APPROXIMATELY 24% OF DICKINSON COUNTY RESIDENTS ARE 65 YEARS OR OLDER, WHILE 19.8% OF THE COUNTY'S RESIDENTS ARE 18 YEARS OR YOUNGER. THE COUNTY IS PRIMARILY WHITE, ACCOUNTING FOR 96% OF THE POPULATION. ALMOST 95% OF RESIDENTS ARE A HIGH SCHOOL GRADUATE OR HIGHER AND 26% PERCENT OF RESIDENTS HOLD A BACHELOR'S DEGREE OR HIGHER. IN 2019, 38.4% OF DICKINSON COUNTY RESIDENTS WERE BELOW THE ALICE THRESHOLD AND STRUGGLED TO MAKE ENDS MEET. THE MEDIAN HOUSEHOLD INCOME FROM 2016-2020 IS $51,704. |
| PART VI, LINE 5: | MARSHFIELD MEDICAL CENTER-DICKINSON (MMC-DICKINSON) INVESTED PERSONNEL TIME, FUNDING AND RESOURCES IN ITS COMMUNITY. STAFF ENGAGED IN DIVERSE SECTORS OF THE DICKINSON COUNTY COMMUNITY, WHICH INCLUDED SECTORS FOCUSED ON HEALTH AND HEALTH CARE PRIORITIES AS WELL AS SOCIAL DETERMINANTS OF HEALTH ISSUES. STAFF ALSO PARTICIPATED IN REGIONAL AND STATEWIDE ORGANIZATIONS THAT IMPACT DICKINSON COUNTY. MMC-DICKINSON STAFF PARTICIPATED ACTIVELY ON SEVERAL LOCAL ORGANIZATIONS SUCH AS THE EMERGENCY OPERATIONS COMMITTEE AND INSTANT COMMAND GROUP, LOCAL AND REGIONAL EMERGENCY PLANNING COMMITTEE, AND DICKINSON CHAMBER OF COMMERCE. STAFF INCLUDING MANAGEMENT ARE INVOLVED IN PLANNING, COORDINATING, AND IMPLEMENTING VARIOUS COLLABORATIVE EFFORTS AND INITIATIVES IN THE COMMUNITY. MMC-DICKINSON EMPLOYEES ONE OF THE FEW SANE NURSES IN THE UPPER PENINSULA. SHE PROVIDES TRAININGS AND MENTORING FOR THE COMMUNITY AND FELLOW MEDICAL STAFF. SHE REPRESENTS MMC- DICKINSON WHILE PARTICIPATING IN REGIONAL AND STATE COMMITTEES AND WORKGROUPS ADDRESSING DOMESTIC VIOLENCE, SEXUAL ASSAULT, HUMAN TRAFFICKING, AND OTHER RELATED TOPICS. |
| PART VI, LINE 6: | MARSHFIELD CLINIC WAS FOUNDED IN 1916 BY SIX PHYSICIANS PRACTICING IN MARSHFIELD, A RURAL CENTRAL WISCONSIN CITY. AT ITS INCEPTION, CLINIC FOUNDERS SAW RESEARCH AND EDUCATION AS CRITICAL TO THEIR PRACTICE OF HEALTH CARE AND THAT REMAINS SO TODAY. THE CLINIC BECAME A 501(C)(3) NONPROFIT ORGANIZATION IN 1992 AND IN 2014, MARSHFIELD CLINIC HEALTH SYSTEM, INC. (MCHS), WAS FORMED. MCHS TODAY IS AN INTEGRATED HEALTH SYSTEM SERVING WISCONSIN AND MICHIGAN'S UPPER PENINSULA WITH MORE THAN 12,000 EMPLOYEES INCLUDING MORE THAN 1,600 PROVIDERS COMPRISING OVER 170 SPECIALTIES, A HEALTH PLAN, AND RESEARCH AND EDUCATION PROGRAMS. MCHS PRIMARY OPERATIONS INCLUDE: MARSHFIELD CLINIC; MARSHFIELD MEDICAL CENTER HOSPITALS IN MARSHFIELD, EAU CLAIRE, BEAVER DAM, LADYSMITH, MINOCQUA, NEILLSVILLE, RICE LAKE, STEVENS POINT, WESTON, IRON MOUNTAIN, PARK FALLS, AND MARSHFIELD CHILDREN'S HOSPITAL; MARSHFIELD CLINIC RESEARCH INSTITUTE, SECURITY HEALTH PLAN, AND MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION.UNIQUE TO MCHS IS ITS CENTER FOR COMMUNITY HEALTH ADVANCEMENT (CCHA), WHICH BUILDS BRIDGES BETWEEN THE HEALTHCARE SYSTEM AND THE PLACES IN THE COMMUNITY WHERE PEOPLE LIVE, WORK AND PLAY. THE CCHA WORKS WITH COALITIONS, BUSINESSES, EDUCATIONAL SYSTEMS, LAW ENFORCEMENT AGENCIES, TRIBAL NATIONS, LOCAL GOVERNMENTS, AND OTHER HEALTHCARE PROVIDERS, NONPROFIT ORGANIZATIONS AND OTHER ENTITIES TO IMPROVE COMMUNITY HEALTH. THE CCHA INCLUDES HOSPITAL STAFF WHO ARE CLOSELY INVOLVED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY (IS) IN THEIR RESPECTIVE COUNTIES. THIS HELPS TO ALIGN COMMUNITY HEALTH PRIORITIES IDENTIFIED IN THE CHNA WITH HEALTH SYSTEM PRIORITIES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUSAN TURNEY MD | ||||||||||||||
| BOARD MEMBER/MCHS CEO | $0 | $1,812,322 | $0 | $910,520 | $0 | $325,650 | $0 | $287,565 | $0 | $27,779 | $0 | $3,363,836 | $0 | $258,588 |
| JERARD JENSEN | ||||||||||||||
| MCHS GENERAL COUNSEL | $0 | $801,522 | $0 | $202,859 | $0 | $54,499 | $0 | $23,031 | $0 | $42,224 | $0 | $1,124,135 | $0 | $0 |
| WILLIAM MELMS MD | ||||||||||||||
| BOARD MEMBER/MCHS CMO | $0 | $784,186 | $0 | $5,000 | $0 | $40,227 | $0 | $23,031 | $0 | $34,024 | $0 | $886,468 | $0 | $0 |
| GORDON EDWARDS | ||||||||||||||
| MCHS CFO/COO - PART YEAR | $0 | $560,115 | $0 | $166,037 | $0 | $103,493 | $0 | $9,150 | $0 | $22,602 | $0 | $861,397 | $0 | $0 |
| SARAH VENDITTI MD | ||||||||||||||
| PHYSICIAN | $631,036 | $0 | $149,738 | $0 | $59,765 | $0 | $7,063 | $0 | $8,869 | $0 | $856,471 | $0 | $0 | $0 |
| MARYAM HAMIDI MD | ||||||||||||||
| PHYSICIAN | $626,731 | $0 | $40,000 | $0 | $0 | $0 | $0 | $0 | $9,016 | $0 | $675,747 | $0 | $0 | $0 |
| ERIC JOHNSON MD | ||||||||||||||
| PHYSICIAN | $483,509 | $0 | $18,000 | $0 | $70,576 | $0 | $0 | $0 | $17,729 | $0 | $589,814 | $0 | $0 | $0 |
| RUWAN DISSANAYAKE MD | ||||||||||||||
| SECRETARY | $0 | $398,039 | $0 | $103,133 | $0 | $27,384 | $0 | $21,612 | $0 | $32,703 | $0 | $582,871 | $0 | $0 |
| ADINA-MARIA ANDERSON DPM | ||||||||||||||
| PHYSICIAN | $445,571 | $0 | $1,621 | $0 | $33,644 | $0 | $3,332 | $0 | $13,718 | $0 | $497,886 | $0 | $0 | $0 |
| ADAM RYAN MD | ||||||||||||||
| PHYSICIAN | $446,305 | $0 | $28,754 | $0 | $3,585 | $0 | $0 | $0 | $6,611 | $0 | $485,255 | $0 | $0 | $0 |
| KATHY BRESSLER | ||||||||||||||
| MCHS COO | $0 | $285,062 | $0 | $25,000 | $0 | $60,717 | $0 | $8,769 | $0 | $8,105 | $0 | $387,653 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE MARSHFIELD CLINIC HEALTH SYSTEM'S (MCHS) INDEPENDENT COMPENSATION COMMITTEE (THE COMMITTEE) HAS FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL DISQUALIFIED PERSONS EMPLOYED BY ANY OF THE ORGANIZATIONS IN THE SYSTEM. THE COMMITTEE USES COMBINATIONS OF THE FOLLOWING TO EVALUATE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE, AND WRITTEN EMPLOYMENT CONTRACTS. |
| PART I, LINE 4B | THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN AND RECEIVED A DISTRIBUTION FROM OR HAD AMOUNTS VEST IN THE PLAN: SUSAN TURNEY, MD - 219,744 THE FOLLOWING INDIVIDUALS PARTICATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN BUT DID NOT RECEIVE A DISTRIBUTION OR HAVE AN AMOUNT VEST IN THE PLAN. UNDER THE PLAN, AMOUNTS DO NOT VEST UNTIL TWO YEARS AFTER SEPARATION FROM THE ORGANIZATION: RUWAN DISSANAYAKE, MD JERARD JENSEN GORDON EDWARDS WILLIAM MELMS, MD |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| DICKINSON COUNTY HEALTHCARE SYSTEM | ||||||||
| A | 382780429 | NONEAVAIL | 2004-08-03 | $5,000,000 | SEE SUPPLEMENTAL INFO | 0 | 0 | 0 |
| UNITED STATES DEPARTMENT OF AGRICULTURE | ||||||||
| B | 720564834 | NONEAVAIL | 2021-10-05 | $16,900,000 | SEE SUPPLEMENTAL INFO | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Other Spent ProceedsOtherSpentProceedsAmt |
|---|---|---|---|---|---|---|---|---|---|---|
| A | $2,874,668 | $5,042,506 | $50,050 | $4,949,950 | 2006 | 0 | 0 | Yes (1) | Yes (1) | |
| B | $612,929 | $16,900,000 | $400,000 | $9,535,520 | 0 | 0 | Yes (1) | Yes (1) | $6,964,480 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE K, PART I, BOND ISSUES: | (A) ISSUER NAME: DICKINSON COUNTY HEALTHCARE SYSTEM (F) DESCRIPTION OF PURPOSE: CONSTRUCT AN ADDITION TO THE HOSPITAL FACILITY, RENOVATE EXISTING HOSPITAL FACILITY SPACE AND RELATED EQUIPMENT. |
| SCHEDULE K, PART I, BOND ISSUES: | (A) ISSUER NAME: UNITED STATES DEPARTMENT OF AGRICULTURE (F) DESCRIPTION OF PURPOSE: PURCHASE MAJOR MEDICAL EQUIPMENT AND RETIRE OTHER PRIVATE DEBT. |
| PART II, LINE 3, COLUMN A: | THE TOTAL PROCEEDS EXCEEDS THE ISSUE PRICE DUE TO INVESTMENT EARNINGS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 1, SECTION B, INITIAL RETURN: | DICKINSON COUNTY HEALTHCARE SYSTEM WAS INCORPORATED ON SEPTEMBER 14, 1990 UNDER MICHIGAN LAW AS A COUNTY PUBLIC HOSPITAL. SINCE ITS FORMATION, THE HOSPITAL HAS OPERATED AS AN ACUTE CARE AND OUTPATIENT HEALTH CARE COUNTY PUBLIC HOSPITAL SERVING THE COMMUNITY IN DICKINSON COUNTY, MICHIGAN. AS A STATE INSTRUMENTALITY, CONTROLLED BY DICKINSON COUNTY, MICHIGAN, THE HOSPITAL HAS BEEN EXEMPT FROM THE IRS FORM 990 SERIES FILING REQUIREMENTS. EFFECTIVE FEBRUARY 1, 2022, MCHS HOSPITALS, INC BECAME THE SOLE CORPORATE MEMBER OF DICKINSON COUNTY HEALTHCARE SYSTEM THROUGH A MEMBER SUBSTITUTION. AT THE SAME TIME, DICKINSON COUNTY HEALTHCARE SYSTEM APPLIED FOR AND RECEIVED A 501(C)(3) EXEMPTION SINCE FOLLOWING THE TRANSACTION WITH MCHS HOSPITALS, INC., IT IS NO LONGER A GOVERNMENTAL UNIT OR INSTRUMENTALITY THAT IS TAX-EXEMPT BY REASON OF SUCH STATUS. AS SUCH, DICKINSON COUNTY HEALTHCARE SYSTEM, IS FILING AN INITIAL FORM 990 FOR THE TAX YEAR 2022. |
| FORM 990, PART VI, SECTION A, LINE 6 | MCHS HOSPITALS, INC. (A WISCONSIN NONSTOCK, NONPROFIT ORGANIZATION DESCRIBED IN CODE SECTION 501(C)(3)) IS THE SOLE MEMBER OF DICKINSON COUNTY HEALTHCARE SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7A | MCHS HOSPITALS, INC. (AS THE SOLE MEMBER) HAS THE RESERVE POWER TO APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS OF DICKINSON COUNTY HEALTHCARE SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7B | MCHS HOSPITALS, INC. (THE SOLE MEMBER) HAS THE RIGHT TO APPROVE ANY CHANGES TO THE ARTICLES OF INCORPORATION AND BYLAWS OF DICKINSON COUNTY HEALTHCARE SYSTEM. MCHS HOSPITALS, INC. (THE SOLE MEMBER) HAS THE RIGHT TO INITIATE AND APPROVE LONG-TERM BORROWING AND OTHER FORMS OF LONG-TERM INDEBTEDNESS, INITIATE AND APPROVE THE PURCHASE, SALE OR ENCUMBRANCE OF REAL AND PERSONAL PROPERTY AND APPROVE OR DISAPPROVE ANNUAL OPERATING AND CAPITAL BUDGETS. MCHS HOSPITALS, INC. (THE SOLE MEMBER) ALSO HAS THE RIGHT TO INITIATE AND APPROVE ANY OF THE FOLLOWING ACTIONS: MERGER, CONSOLIDATION, AFFILIATION OR JOINT VENTURE WITH ANY OTHER ENTITY OR ENTITIES; LIQUIDATION, REORGANIZATION OR DISSOLUTION OF THE ORGANIZATION; FILING OF A VOLUNTARY PETITION IN BANKRUPTCY; ANY CHANGE IN CONTROL OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | MARSHFIELD CLINIC HEALTH SYSTEM, INC. ENGAGES A PUBLIC ACCOUNTING FIRM TO PREPARE AND REVIEW THE FORM 990 IN ADDITION TO REVIEW BY THE SYSTEM CFO, VP OF FINANCE AND TAX DEPARTMENT. PRIOR TO FILING THE FORM WITH THE IRS, THE CFO AND HIS/HER DESIGNEE WILL PROVIDE TO EACH MEMBER OF THE SYSTEM'S AUDIT AND COMPLIANCE COMMITTEE (A SUBCOMMITTEE OF THE BOARD OF DIRECTORS) A COPY IN ELECTRONIC OR PAPER FORM OF THE COMPLETED FORM 990 (AND ALL REQUIRED SCHEDULES) FOR REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL OFFICERS, BOARD DIRECTORS, AND KEY EMPLOYEES OF EVERY MARSHFIELD CLINIC HEALTH SYSTEM (MCHS) ENTITY, AS WELL AS ANY OTHER PERSON DESIGNATED BY THE AUDIT AND COMPLIANCE COMMITTEE (ACC) TO BE A REQUIRED REPORTER BY VIRTUE OF HIS OR HER POSITION AT A SYSTEM ENTITY, SHALL ANNUALLY COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. SUCH FORMS SHALL BE DISTRIBUTED AND RECORDED BY THE SYSTEM'S DESIGNATED COMPLIANCE OFFICER. ALL FINANCIAL INTERESTS DISCLOSED AS PART OF THE ANNUAL DISCLOSURE PROCESS SHALL BE REVIEWED BY THE ACC. THE ACC SHALL INFORM THE BOARD OF DISCLOSED FINANCIAL INTERESTS WHICH MAY BEAR UPON OR RELATE TO A TRANSACTION UPON WHICH THE BOARD OR ANOTHER BOARD, COMMITTEE OR OTHER BODY OF A SYSTEM ENTITY, MAY DELIBERATE OR ACT. IN ADDITION TO THE ANNUAL DISCLOSURES, IF AT ANY TIME BETWEEN ANNUAL DISCLOSURES, A REQUIRED REPORTER BECOMES AWARE THAT THE BOARD, OR A BOARD, COMMITTEE OR OTHER BODY, OF ANY SYSTEM ENTITY MAY DELIBERATE OR ACT UPON ANY TRANSACTION THAT MAY HAVE ANY BEARING OF ANY KIND UPON, OR MAY RELATE IN ANY MANNER TO, AN EXISTING, INTENDED OR EXPECTED FINANCIAL INTEREST OF THE REQUIRED REPORTER, HE OR SHE SHALL DISCLOSE THE FINANCIAL INTEREST TO THE RELEVANT SYSTEM ENTITY BOARD, COMMITTEE OR BODY CHAIR, AS WELL AS TO THE SYSTEM'S COMPLIANCE OFFICER, IN ADVANCE OF ANY DELIBERATIONS OR ACTION, WRITTEN DISCLOSURE OF THE EXISTENCE, NATURE AND EXTENT OF HIS OR HER FINANCIAL INTEREST. ALL WRITTEN OR ORAL DISCLOSURES OF FINANCIAL INTERESTS SHALL BE RECORDED IN THE MINUTES OF THE BOARD AND BY THE OFFICE OF THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER SHALL DISCLOSE THE COMPLETED FORMS AS NECESSARY TO THOSE MCHS EMPLOYEES RESPONSIBLE FOR COMPLETION OF THE IRS FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE (COMPENSATION COMMITTEE) SHALL HAVE FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL DISQUALIFIED PERSONS (AS THAT TERM IS DEFINED IN 4958 OF THE INTERNAL REVENUE CODE (THE CODE)) EMPLOYED BY THE CORPORATION, INCLUDING BUT NOT LIMITED TO THE CORPORATION'S CEO. THE TERM DISQUALIFIED PERSONS INCLUDES (BUT IS NOT LIMITED TO) ANY PERSON (OR THE PERSON'S FAMILY MEMBER) WHO WAS, AT ANY TIME DURING THE 5-YEAR PERIOD ENDING ON THE DATE OF THE TRANSACTION, IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. IT SHALL BE THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE TO INSURE THAT THE SYSTEM DOES NOT PAY AN AMOUNT THAT EXCEEDS REASONABLE COMPENSATION FOR ANY DISQUALIFIED PERSON. THE COMPENSATION COMMITTEE AND ITS OPERATING PROCEDURES SHALL BE DESIGNED TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS OF COMPENSATION OUTLINED IN TREASURY REG. SEC. 53.4958-6 WITH RESPECT TO EACH DISQUALIFIED PERSON. IN DETERMINING REASONABLENESS OF COMPENSATION, THE COMPENSATION COMMITTEE SHALL EVALUATE APPROPRIATE INFORMATION AS TO THE COMPARABILITY OF COMPENSATION, INCLUDING BUT NOT LIMITED TO: COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR COMPARABLE POSITIONS; THE AVAILABILITY OF SIMILAR SERVICES IN THE SYSTEM'S GEOGRAPHIC AREA; CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL WRITTEN JOB OFFERS FROM SIMILAR INSTITUTIONS. THE COMPENSATION COMMITTEE SHALL HAVE INDEPENDENT AUTHORITY TO OBTAIN OUTSIDE EXPERT OPINIONS ON THE REASONABLENESS AND FAIR MARKET VALUE OF COMPENSATION AND GATHER OTHER INFORMATION IT CONSIDERS NECESSARY OR APPROPRIATE TO MAKE ITS DECISIONS ON COMPENSATION. THE COMPENSATION COMMITTEE SHALL TIMELY DOCUMENT ITS DETERMINATION OF REASONABLENESS OF COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | DICKINSON COUNTY HEALTHCARE SYSTEM DOES NOT MAKE ITS CURRENT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UNLESS INCLUDED AS PART OF A FORM THAT IS REQUIRED TO BE PUBLICLY AVAILABLE. |
| FORM 990, PART IX, LINE 11G | OTHER: PROGRAM SERVICE EXPENSES 23,077,924. MANAGEMENT AND GENERAL EXPENSES 755,587. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,833,511. |
| FORM 990, PART XI, LINE 9: | NET ASSETS RELEASED FROM RESTRICTION 118,800. CAPITAL CONTRIBUTION FROM PARENT ORGANIZATION 18,886,696. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| FLAMBEAU HOSPITAL INC | |||||||||||
| 98 SHERRY AVE | PARK FALLS | WI | 54552 | 390973724 | HOSPITAL | WI | 501(C)(3) | LINE 3 | MCHS HOSP | 0 | |
| MARSHFIELD CLINIC HEALTH SYSTEM INC | |||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 461495343 | SUPPORT ORG | WI | 501(C)(3) | LINE 12D, III-O | 0 | N/A | |
| VOLUNTEER PARTNERS OF LAKEVIEW MEDICAL | |||||||||||
| 1700 W STOUT ST | RICE LAKE | WI | 54868 | 391329084 | SUPPORT ORG | WI | 501(C)(3) | LINE 12D, III-O | 0 | N/A | |
| FAMILY HEALTH CENTER OF MARSHFIELD INC | |||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 391681547 | COM HLTH CTR | WI | 501(C)(3) | LINE 7 | 0 | N/A | |
| MARSHFIELD CLINIC INC | |||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 390452970 | MEDICAL SVCS | WI | 501(C)(3) | LINE 3 | MCHS | 0 | |
| SECURITY HEALTH PLAN OF WISCONSIN INC | |||||||||||
| 1515 N ST JOSEPH AVE | MARSHFIELD | WI | 54449 | 391572880 | HMO | WI | 501(C)(4) | N/A | MCHS | 0 | |
| MCHS HOSPITALS INC | |||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 810977948 | HOSPITAL | WI | 501(C)(3) | LINE 3 | MCHS | 0 | |
| MCHS FOUNDATION INC | |||||||||||
| 1000 N OAK AVE | MARSHFIELD | WI | 54449 | 812822823 | PHILANTHROPY | WI | 501(C)(3) | LINE 7 | MCHS | 0 | |
| BEAVER DAM COMMUNITY HOSPITALS INC | |||||||||||
| 707 S UNIVERSITY AVE | BEAVER DAM | WI | 53916 | 391157876 | HOSPITAL | WI | 501(C)(3) | LINE 3 | MCHS HOSP | 0 | |
| MEMORIAL HOSPITAL INC | |||||||||||
| N3708 RIVER AVE | NEILLSVILLE | WI | 54456 | 390806828 | HOSPITAL | WI | 501(C)(3) | LINE 3 | MCHS HOSP | 0 | |
| DICKINSON HOSPITALS FOUNDATION | |||||||||||
| 1721 S STEPHENSON AVE | IRON MOUNTAIN | MI | 49801 | 386093161 | PHILANTHROPY | MI | 501(C)(3) | LINE 7 | DCHS | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE DIAGNOSTIC & TREATMENT CENTER LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3401 CRANBERRY BLVD | AddressLine1Txt |
| City | WESTON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54476 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200691634 | EIN |
| Primary Activities | MEDICAL SVCS | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| 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 | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | 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 | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |