VERNON MEMORIAL HEALTHCARE INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- VERNON MEMORIAL HEALTHCARE INC (EIN 39-0806404)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-08-15
- IRS object ID
- 202222279349302287
- Schema version
- 2020v4.2
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-15T12:12:17-05:00 | ReturnTs |
| Tax Period End | 2021-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390806404 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VERNON MEMORIAL HEALTHCARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | VERN | BusinessNameControlTxt |
| Phone | 6086372101 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 507 SOUTH MAIN STREET | AddressLine1Txt |
| City | VIROQUA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54665 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT LECKEY | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6086372101 | PhoneNum |
| Signature | 2022-08-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SCOTT | PersonFirstNm |
| Person Last | LECKEY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2022-08-09 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID HARTBERG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 507 SOUTH MAIN STREET | AddressLine1Txt |
| City | VIROQUA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54665 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $91,845,482 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.VMH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1946 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | VERNON MEMORIAL HEALTHCARE, INC. WILL STRIVE TO HAVE THE VISION TO CONTINUALLY PROVIDE THE HIGHEST STANDARD OF CARE TO OUR PATIENTS AND THEIR FAMILIES WHILE BEING 'CLOSE TO HOME.' OUR MISSION AFFIRMS OUR COMMITMENT TO BEING THE BEST COMMUNITY HEALTHCARE SYSTEM IN THE REGION. IN SUPPORT OF THIS MISSION, WE CONSIDER IT ESSENTIAL TO PROVIDE COST-EFFECTIVE, ACCESSIBLE CARE AND SERVICES USING PROFESSIONAL TREATMENT TO THE INJURED, AFFLICTED, AND WELL PEOPLE WHO NEED THE RESOURCES WE HAVE AT OUR COMMAND, WITHOUT REGARD TO RACE, CREED, COLOR, SEX, HANDICAP, NATIONAL ORIGIN, OR ABILITY TO PAY. IT IS OUR INTENTION TO ENSURE THAT IN EACH AND EVERY CASE OUR PATIENTS SHALL BE TREATED WITH COMPASSION, UNDERSTANDING AND DIGNITY. FURTHER, THE RIGHTS AND PRIVILEGES OF THE PEOPLE WE SERVE SHALL ALWAYS BE HELD IN THE HIGHEST REGARD, AND THEIR WELL-BEING MUST ALWAYS HAVE FIRST CONSIDERATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 623 | TotalEmployeeCnt |
| Total Volunteers | 85 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,915,153 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,601,406 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $74,131,912 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $78,538,766 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,874,731 | PYInvestmentIncomeAmt |
| CY Investment Income | -$459,984 | CYInvestmentIncomeAmt |
| PY Other Revenue | $284,722 | PYOtherRevenueAmt |
| CY Other Revenue | $299,822 | CYOtherRevenueAmt |
| PY Total Revenue | $80,206,518 | PYTotalRevenueAmt |
| CY Total Revenue | $82,980,010 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $14,703 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $37,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $37,679,616 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $36,646,913 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $35,026,314 | PYOtherExpensesAmt |
| CY Other Expenses | $36,496,441 | CYOtherExpensesAmt |
| PY Total Expenses | $72,720,633 | PYTotalExpensesAmt |
| CY Total Expenses | $73,180,354 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,485,885 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $9,799,656 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $109,351,678 | TotalAssetsBOYAmt |
| Total Assets EOY | $121,939,170 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $31,616,627 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $31,827,955 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $77,735,051 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $90,111,215 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE ARE COMMITTED TO BEING THE BEST COMMUNITY HEALTHCARE SYSTEM IN THE REGION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $58,025,731 | ExpenseAmt |
| Grant | $37,000 | GrantAmt |
| Revenue | $74,342,472 | RevenueAmt |
| Desc | VERNON MEMORIAL HEALTHCARE ("VMH") OPERATES A 25-BED CRITICAL ACCESS HOSPITAL LOCATED IN VIROQUA, WISCONSIN, FOUR PROVIDER-BASED RURAL HEALTH CLINICS (VIROQUA, LA FARGE, SOLDIERS GROVE, AND WESTBY), AND THREE RETAIL PHARMACY LOCATIONS. VMH MAINTAINS A CLEAR AND CONSISTENT COMMITMENT TO ITS CHARITABLE PURPOSE THROUGH THE PROVISION OF HEALTH AND WELLNESS SERVICES TO THE COMMUNITIES SERVED WITHOUT REGARD TO AGE, RACE, GENDER, CREED, NATIONAL ORIGINAL, ABILITY TO PAY, AND PHYSICAL OR MENTAL HANDICAP. VMH'S DEDICATED WORKFORCE EXEMPLIFY SERVICE IN ALIGNMENT WITH ORGANIZATIONAL VALUE STATEMENTS: GREAT EXPERIENCES. RESPECTING EVERYONE. EXCELLENCE IN EVERYTHING WE DO. ALWAYS A HELPFUL ATTITUDE. TAKING CARE OF ONE ANOTHER.IN RESPONSE TO THE NEEDS OF THE COMMUNITIES SERVED, VMH IS PROUD TO PROVIDE HIGH QUALITY INPATIENT ACUTE CARE FOR MEDICAL, SURGICAL, OBSTETRICAL, AND NEWBORN SERVICE NEEDS. VMH FURTHER SUPPORTS THE NEEDS OF ITS PATIENTS BY OFFERING ACCESS TO SWING BED (SKILLED) NURSING CARE. WITH A CONSTANT FOCUS ON QUALITY AND PATIENT SAFETY, VMH OFFERS OUTPATIENT AND ANCILLARY HEALTHCARE SERVICES INCLUDING 24-HOUR EMERGENCY SERVICES, SURGICAL SERVICES, LABORATORY, X-RAY, ULTRASOUND, CT SCANS, MRI, MAMMOGRAPHY, CARDIAC REHABILITATION, SLEEP STUDY SERVICES, INFUSION AND GASTROINTESTINAL SERVICES, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, AND NUTRITIONAL THERAPY INCLUDING DIABETIC EDUCATION. PATIENTS SERVED BY THE HOSPITAL IN FISCAL 2021 INCLUDED 3,530 ADULT AND PEDIATRIC INPATIENT DAYS AND 135 NEWBORN DELIVERIES. THERE WAS A TOTAL OF 1,314 SURGERY CASES (INPATIENT AND OUTPATIENT COMBINED) AND THERE WERE 94,539 TOTAL OUTPATIENT VISITS. THE VMH EMERGENCY ROOM PROVIDED IMMEDIATE ACCESS TO CARE IN RESPONSE TO 6,840 EMERGENCY ROOM VISITS.AS A PART OF VMH'S MISSION, AND IN KEEPING WITH ITS STATUS AS A NOT-FOR-PROFIT HEALTHCARE ORGANIZATION, VMH HAS ESTABLISHED A PATIENT FINANCIAL ASSISTANCE POLICY THAT SETS FORWARD THE CRITERIA BY WHICH A PATIENT MAY QUALIFY TO RECEIVE CARE AT AMOUNTS LESS THAN THE ESTABLISHED RATES; TO RECEIVE CHARITY CARE. VMH MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE PROVIDED, THE TOTAL HEALTHCARE SERVICES PROVIDED TO PATIENTS UNDER THIS POLICY ARE MEASURED IN BOTH TOTAL CHARGES AND AT THE ESTIMATED COST OF PROVIDING CARE TO PATIENTS WITH BOTH FIGURES REPORTED AND AVAILABLE BY REFERRING TO SCHEDULE H. IN ADDITION, VMH IS A PROVIDER UNDER THE WISCONSIN MEDICAID PROGRAM. UNDER THE PROGRAM, VMH IS LEGALLY BOUND TO ACCEPT THE AMOUNT DETERMINED BY THE STATE OF WISCONSIN AS PAYMENT IN FULL FOR EACH PATIENT'S CHARGES EVEN THOUGH REIMBURSEMENT IS LESS THAN THE COST TO PROVIDE THE CARE, THEREFORE, SERVICE TO PATIENTS UNDER THIS PROGRAM SHOULD ALSO BE CONSIDERED PART OF THE ORGANIZATION'S BENEFIT PROVIDED TO THE COMMUNITY. (FOR ADDITIONAL INFORMATION ON VMH'S CHARITY CARE AND/OR THE COST OF PARTICIPATION IN THE WISCONSIN MEDICAID PROGRAM, PLEASE REFER TO SCHEDULE H OF THE FORM 990.) IN ADDITION, VMH ENGAGES IN A VARIETY OF COMMUNITY BENEFIT ACTIVITIES, PROVIDING A CRITICALLY IMPORTANT COMMUNITY BENEFIT THAT WOULD NOT OTHERWISE BE AVAILABLE IN THE COMMUNITIES SERVED WITHOUT THE EFFORTS AND SPECIALIZED KNOWLEDGE OF THE LOCAL HEALTHCARE TEAM. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,275,288 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $4,196,294 | RevenueAmt |
| Desc | VERNON MEMORIAL HEALTHCARE, INC. OPERATES FOUR RURAL HEALTH CLINICS LOCATED IN VIROQUA, LAFARGE, SOLDIERS GROVE, AND WESTBY. TOGETHER, THESE CLINICS STRIVE TO MEET THE HEALTHCARE NEEDS OF PATIENTS AND FAMILIES WHO LIVE AND WORK IN THE COMMUNITIES THEY SERVE. A TOTAL OF 34,571 RURAL HEALTH CLINIC VISITS OCCURRED IN FISCAL YEAR 2021. THE CLINICS ARE DESIGNATED AS RURAL HEALTH CLINICS BY THE MEDICARE AND MEDICAID PROGRAMS AND, BY DEFINITION OF THE REQUIREMENTS FOR THAT DESIGNATION, ARE LOCATED IN RURAL OR UNDERSERVED AREAS OF THE COUNTRY. THESE CLINICS PROVIDE CARE TO A LARGE PORTION OF MEDICARE AND MEDICAID BENEFICIARIES WHO, WITHOUT ACCESS TO CARE LOCALLY, WOULD BE REQUIRED TO TRAVEL FARTHER DISTANCES FOR QUALITY HEALTHCARE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $61,301,019 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | Yes (1) | 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 | 63 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 623 | 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 | 9 | 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 | 0 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCOTT LECKEY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6086374964 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 507 SOUTH MAIN STREET | AddressLine1Txt |
| City | VIROQUA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54665 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| NATHAN CAMPBELL | |||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARILYN CLAUSON | |||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PAUL LARSEN | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KATHY STITTLEBURG | |||||||
| TREASURER (THRU DECEMBER) | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| VICKI ANDERSON | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVE SARNOWSKI | |||||||
| SECRETARY (THRU DECEMBER) | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARY GAJEWSKI | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MELISSA HUGHES | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| STACY KRING | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DORI MICKELSON | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SHARON NELSON | |||||||
| MEMBER (THRU OCTOBER) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOAN PETERSON | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TOM WESTON | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SCOTT LECKEY | |||||||
| CFO | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| KAREN TRAYNOR | |||||||
| CFO (THRU JULY) | 40.00 | Yes (X) | $255,580 | $0 | $5,281 | ||
| DAVID HARTBERG | |||||||
| CEO | 40.00 | Yes (X) | $303,028 | $0 | $25,429 | ||
| DR BRIAN LYLE | |||||||
| PHYSICIAN | 40.00 | $482,648 | $0 | $14,359 | Yes (X) | ||
| DR ANTHONY MACASAET | |||||||
| ER PHYSICIAN | 30.00 | $356,106 | $0 | $25,448 | Yes (X) | ||
| BRIAN MILLER | |||||||
| CRNA | 40.00 | $369,957 | $0 | $61,882 | Yes (X) | ||
| DR ANDREW MANSPEAKER | |||||||
| ER PHYSICIAN | 36.00 | $373,135 | $0 | $31,398 | Yes (X) | ||
| JEFFREY SCHEIDT | |||||||
| CRNA | 40.00 | $372,459 | $0 | $30,583 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,512,913 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $194,380 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 56 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BURLINGTON HEALTHCARE PROVIDERS | |||||
| W329 N 4476 LAKELAND DR | NASHOTA | WI | 53122 | STAFFING SERVICE, EMERGENCY PHYSICIANS | $422,344 |
| ATLAS PHYSICIANS MIDWEST | |||||
| 125 N 123RD ST | WAUWATOSA | WI | 53226 | STAFFING SERVICE | $263,912 |
| WIPFLI LLP | |||||
| PO BOX 3160 | MILWAUKEE | WI | 53201 | ACCOUNTING/LAW FIRM SERVICES | $123,387 |
| JEFFREY M LAWRENCE MD | |||||
| E8869 APPLE LANE | VIROQUA | WI | 54665 | SURGEON SERVICES | $114,813 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,499,297 | GovernmentGrantsAmt |
| All Other Contributions | $102,109 | AllOtherContributionsAmt |
| Total Contributions | $4,601,406 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOSPITAL | 621990 | $66,725,992 | $66,725,992 |
| RETAIL PHARMACY | 446110 | $7,468,954 | $7,468,954 |
| CLINIC | 621110 | $4,196,294 | $4,196,294 |
| CBRF | 623000 | $147,526 | $147,526 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $78,538,766 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $604,227 | TotalRevenueColumnAmt |
| Exclusion | $604,227 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $299,822 | 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 | $299,822 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $299,822 | TotalRevenueColumnAmt |
| Exclusion | $299,822 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,051,426 | SecuritiesAmt |
| Other | $749,835 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,079,527 | SecuritiesAmt |
| Other | $2,785,945 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $971,899 | SecuritiesAmt |
| Other | -$2,036,110 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,064,211 | TotalRevenueColumnAmt |
| Exclusion | -$1,064,211 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $82,980,010 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $78,538,766 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$160,162 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,000 | TotalAmt |
| Program Services | $35,000 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,000 | TotalAmt |
| Program Services | $2,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $785,422 | TotalAmt |
| Management And General | $785,422 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,809,941 | TotalAmt |
| Program Services | $24,597,607 | ProgramServicesAmt |
| Management And General | $4,212,334 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $778,222 | TotalAmt |
| Program Services | $685,126 | ProgramServicesAmt |
| Management And General | $93,096 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,329,279 | TotalAmt |
| Program Services | $3,735,548 | ProgramServicesAmt |
| Management And General | $593,731 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,944,049 | TotalAmt |
| Program Services | $1,667,564 | ProgramServicesAmt |
| Management And General | $276,485 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $313,536 | TotalAmt |
| Management And General | $313,536 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,387 | TotalAmt |
| Management And General | $123,387 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,886,349 | TotalAmt |
| Program Services | $5,679,456 | ProgramServicesAmt |
| Management And General | $1,206,893 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,526 | TotalAmt |
| Program Services | $147,323 | ProgramServicesAmt |
| Management And General | $32,203 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $376,498 | TotalAmt |
| Program Services | $161,981 | ProgramServicesAmt |
| Management And General | $214,517 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $882,250 | TotalAmt |
| Management And General | $882,250 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,273,067 | TotalAmt |
| Program Services | $961,809 | ProgramServicesAmt |
| Management And General | $1,311,258 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,548 | TotalAmt |
| Program Services | $14,353 | ProgramServicesAmt |
| Management And General | $28,195 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,332 | TotalAmt |
| Program Services | $99,946 | ProgramServicesAmt |
| Management And General | $17,386 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $955,510 | TotalAmt |
| Program Services | $799,875 | ProgramServicesAmt |
| Management And General | $155,635 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,231,621 | TotalAmt |
| Program Services | $3,549,833 | ProgramServicesAmt |
| Management And General | $681,788 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,359 | TotalAmt |
| Program Services | $38,910 | ProgramServicesAmt |
| Management And General | $210,449 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHARMACEUTICALS | $7,843,046 | $7,843,046 | |
| SUPPLIES | $7,352,359 | $7,334,315 | $18,044 |
| BAD DEBT EXPENSE | $2,604,232 | $2,604,232 | |
| EQUIPMENT RENTAL & MAIN | $1,195,850 | $1,062,104 | $133,746 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $869,971 | TotalAmt |
| Program Services | $280,991 | ProgramServicesAmt |
| Management And General | $588,980 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,180,354 | TotalAmt |
| Program Services | $61,301,019 | ProgramServicesAmt |
| Management And General | $11,879,335 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,882,131 | BOYAmt |
| EOY | $31,428,122 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,955,149 | BOYAmt |
| EOY | $11,559,783 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,182,878 | BOYAmt |
| EOY | $236,224 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,132,211 | BOYAmt |
| EOY | $7,629,455 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,435,540 | BOYAmt |
| EOY | $2,690,001 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $427,787 | BOYAmt |
| EOY | $351,890 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $89,761,623 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $51,566,565 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,173,975 | BOYAmt |
| EOY | $38,195,058 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,960,301 | BOYAmt |
| EOY | $25,985,909 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $158,335 | BOYAmt |
| EOY | $112,501 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,043,371 | BOYAmt |
| EOY | $3,750,227 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $109,351,678 | BOYAmt |
| EOY | $121,939,170 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,027,891 | BOYAmt |
| EOY | $5,661,788 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,300,000 | BOYAmt |
| EOY | $7,757,510 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,363,541 | BOYAmt |
| EOY | $15,504,945 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,017,329 | BOYAmt |
| EOY | $565,693 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,907,866 | BOYAmt |
| EOY | $2,338,019 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,616,627 | BOYAmt |
| EOY | $31,827,955 | 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 | $76,511,667 | BOYAmt |
| EOY | $89,834,485 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,223,384 | BOYAmt |
| EOY | $276,730 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,735,051 | BOYAmt |
| EOY | $90,111,215 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $109,351,678 | BOYAmt |
| EOY | $121,939,170 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $9,799,656 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,576,508 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $4,923 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,923 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | VERNON MEMORIAL HEALTHCARE, INC. PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION AND RURAL WISCONSIN HEALTH COOPERATIVE. THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. A SMALL PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,538,608 | OtherCostOrOtherBasisAmt |
| Book Value | $1,538,608 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $65,038,614 | OtherCostOrOtherBasisAmt |
| Depreciation | $34,991,159 | DepreciationAmt |
| Book Value | $30,047,455 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,060,892 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,575,406 | DepreciationAmt |
| Book Value | $6,485,486 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $123,509 | OtherCostOrOtherBasisAmt |
| Book Value | $123,509 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $38,195,058 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED COMPENSATION PLAN LIABILITY - FUNDED | Desc |
| Amt | $2,338,019 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,338,019 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $83,726,508 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $2,576,508 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$2,599,021 | OtherRevenueAmt |
| Revenue Not Reported | -$22,513 | RevenueNotReportedAmt |
| Revenue Subtotal | $83,749,021 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$769,011 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$769,011 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $82,980,010 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $70,581,333 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $70,581,333 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,599,021 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,599,021 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $73,180,354 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | WELLNESS CENTER EXPENSE 5,211. BAD DEBT EXPENSE NET AGAINST REVENUE -2,604,232. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTIONS TO RESTRICTED NET ASSETS 25,057. NET ASSETS RELEASED FROM RESTRICTIONS -794,068. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | WELLNESS CENTER EXPENSE -5,211. BAD DEBT EXPENSE NET AGAINST REVENUE 2,604,232. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | 0 | FPGReferenceFreeCareInd |
| 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 | $656,820 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $656,820 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00900 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,436,495 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,663,989 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $772,506 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01060 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,093,315 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,663,989 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,429,326 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01960 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,093,315 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,663,989 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,429,326 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01960 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,123,434 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $561,717 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $14,197,294 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,927,616 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $269,678 | 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 | Yes (1) | 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 | VERNON MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 507 SOUTH MAIN ST | AddressLine1Txt |
| City | VIROQUA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54665 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.VMH.ORG | WebsiteAddressTxt |
| State License | 1053 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VERNON MEMORIAL HEALTHCARE 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 |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 20 | 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 | SEE PART V, SECTION C, LINE 7D | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE PART V, SECTION C, LINE 7D | OtherWebsiteURLTxt |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 20 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C, LINE 7D | 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 | 0.000000000000 | 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 |
| 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 | HTTPS://WWW.VMH.ORG/MEDIA/IMKNGPCC/FAP-POLICY-6-2022.PDF | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.VMH.ORG/MEDIA/20MLXWEK/2022-FAP-APPLICATION.PDF | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.VMH.ORG/MEDIA/HRIF32AL/BRANDING-BROCHURE-FINANCIALASSISTANCEONL | 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 |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| VERNON MEMORIAL HEALTHCARE, INC. | PART V, SECTION B, LINE 3J: 1. USE OF EPIC ELECTRONIC HEALTH RECORD'S POPULATION HEALTH MANAGEMENT MODULE FOR MONITORING PROCESSES. 2. DIABETIC EDUCATION PROGRAM OFFERS PATIENTS EDUCATION AND SUPPORT ON MANAGING DIABETES AND SUPPORTS OVERALL HEALTH. 3. CARE COORDINATION PROGRAM, WHICH OFFERS SOCIAL WORK SUPPORT TO ASSIST PATIENTS IN REACHING THEIR OPTIMAL HEALTH. 4. PARTNERSHIP WITH VERNON COUNTY PARTNERSHIP COUNCIL, WHICH EXISTS TO DEVELOP AND SUPPORT PROGRAMMING THAT ADDRESSES DRUG, ALCOHOL, AND TOBACCO CONCERNS. 5. VMH OFFERS MENTAL HEALTH SERVICES THROUGH THREE LICENSED CLINICAL SOCIAL WORKERS AND ONE PSYCHIATRIST, WHO ALSO OFFERS CHILD AND ADOLESCENT PSYCHIATRY. WE ARE CURRENTLY RECRUITING ADDITIONAL STAFF. |
| VERNON MEMORIAL HEALTHCARE, INC. | PART V, SECTION B, LINE 5: DATA WAS COLLECTED BY RANDOM HOUSEHOLD SURVEY TO 6,000 HOUSEHOLDS AND WAS STRATIFIED BY COUNTY TO ASSURE THAT EVERY JURISDICTION WOULD BE REPRESENTED. IN ADDITION, A SUPPLEMENTAL CONVENIENCE SURVEY WAS CONDUCTED TO GENERATE SURVEY RESPONSES FROM POPULATIONS THAT MAY HAVE BEEN UNDER-REPRESENTED IN THE RANDOM HOUSEHOLD SURVEY. |
| VERNON MEMORIAL HEALTHCARE, INC. | PART V, SECTION B, LINE 6A: THE COMPASS NOW 2021 PARTNERSHIP WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS:1. GUNDERSEN HEALTH SYSTEM, LA CROSSE2. MAYO CLINIC HEALTH SYSTEM LA CROSSE3. GUNDERSEN ST. JOSEPH'S HOSPITAL AND CLINICS, HILLSBORO4. GUNDERSEN TRI-COUNTY HOSPITAL AND CLINICS, WHITEHALL 5. TOMAH HEALTH, TOMAH |
| VERNON MEMORIAL HEALTHCARE, INC. | PART V, SECTION B, LINE 6B: THE COMPASS NOW 2021 PARTNERSHIP WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING ORGANIZATIONS:1. GREAT RIVERS UNITED WAY2. TREMPEALEAU COUNTY HEALTH DEPARTMENT3. MONROE COUNTY HEALTH DEPARTMENT4. GUNDERSEN HEALTH SYSTEM, LA CROSSE, AS WELL AS GUNDERSEN ST. JOSEPH'S HOSPITAL AND CLINICS IN HILLSBORO AND GUNDERSEN TRI-COUNTY HOSPITAL AND CLINICS IN WHITEHALL5. VERNON COUNTY HEALTH DEPARTMENT6. APTIV, INC.7. LA CROSSE COUNTY HEALTH DEPARTMENT8. BUFFALO COUNTY HEALTH DEPARTMENT9. HOUSTON COUNTY HEALTH DEPARTMENT (MINNESOTA)10. COULEECAP11. MAYO CLINIC HEALTH SYSTEM IN BOTH LA CROSSE AND SPARTA |
| VERNON MEMORIAL HEALTHCARE, INC. | PART V, SECTION B, LINE 7D: PART V, LINE 7A:HTTPS://WWW.GREATRIVERSUNITEDWAY.ORG/WP-CONTENT/UPLOADS/2021/06/2021-COMPASS-NOW-REPORT_FINAL-WEB.PDFPART V, LINE 7B:HTTPS://WWW.GREATRIVERSUNITEDWAY.ORG/WP-CONTENT/UPLOADS/2021/06/2021-COMPASS-NOW-REPORT_FINAL-WEB.PDFPART V, LINE 10A:HTTPS://WWW.VMH.ORG/MEDIA/HYLMLGHQ/COMMUNITY-HEALTH-NEEDS-IMPLEMENTATION-PLAN2021.PDF |
| VERNON MEMORIAL HEALTHCARE, INC. | PART V, SECTION B, LINE 11: THREE OF THE KEY ISSUES IDENTIFIED FOR VERNON COUNTY IN THE 2021 COMPASS NOW CHNA INCLUDE: 1. MENTAL HEALTH, 2. POVERTY/LIVABLE WAGES, 3. CHILDCARE. INCREASED ACCESS TO MENTAL HEALTHCARE SERVICES PER THE 2021 COMMUNITY HEALTHCARE NEEDS ASSESSMENT, "THERE ARE ACCESS ISSUES FOR THESE SERVICES IN VERNON COUNTY. THE PERCENT OF ADULTS THAT NEED TREATMENT AND ARE NOT RECEIVING IT IN VERNON COUNTY IS 56% THE PERCENT OF YOUTH THAT NEED TREATMENT AND ARE NOT RECEIVING IT IN VERNON COUNTY IS 55%". IN ADDITION, 5% OF RANDOM HOUSEHOLD SURVEY (RHS) RESPONDENTS AND 12% OF CONVENIENCE SURVEY (CS) RESPONDENTS REPORTED THEIR ACCESS TO MENTAL HEALTH CARE AS "POOR".VMH IS ATTEMPTING TO EXPAND BEHAVIORAL HEALTH SERVICES, ALONG WITH IDENTIFYING AREA ORGANIZATIONS THAT VMH CAN COLLABORATE WITH IN EXPANDING ACCESS TO PATIENTS IN THE VMH SERVICE AREA.CURRENTLY EMPLOYED MENTAL HEALTH PROVIDERS INCLUDE: ONE PSYCHIATRIST, GENERAL PSYCHIATRY, INCLUDING CHILD AND ADOLESCENT, ONE PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER AND TWO LICENSED CLINICAL SOCIAL WORKERS. VMH IS ACTIVELY RECRUITING ADDITIONAL STAFF. VERNON MEMORIAL HEALTHCARE WILL ALSO RESEARCH WORKING WITH OTHER AREA HEALTHCARE ORGANIZATIONS TO POOL RESOURCES AND PROVIDE IMPROVED ACCESS AND COLLABORATIVELY PUBLICIZE ACCESS OPPORTUNITIES IN THESE COMMUNITIES TO HEIGHTEN AWARENESS.POVERTY/FINANCIAL STABILITYPER THE 2021 COMMUNITY HEALTHCARE NEEDS ASSESSMENT, THE FOLLOWING FACTORS INDICATE POVERTY AND/OR FINANCIAL STABILITY OF VERNON COUNTY RESIDENTS: - 11% OF SURVEY RESPONDENTS FROM VERNON COUNTY REPORT THEY ARE UNINSURED. - 46% OF SURVEY RESPONDENTS FROM VERNON COUNTY REPORT A HOUSEHOLD INCOME OF LESS THAN $50,000 PER YEAR (23% REPORT A HOUSEHOLD INCOME OF LESS THAN $25,000 PER YEAR).VMH INFORMS PATIENTS OF FINANCIAL ASSISTANCE AND/OR CHARITY CARE WHEN THEY RECEIVE HEALTHCARE AT VERNON MEMORIAL HEALTHCARE. INFORMATION ABOUT FINANCIAL ASSISTANCE IS AVAILABLE AT PATIENT REGISTRATION DESKS AND ON THE VERNON MEMORIAL HEALTHCARE WEBSITE. PATIENTS ARE ALSO VERBALLY INFORMED OF FINANCIAL ASSISTANCE OPTIONS. IN ADDITION, VERNON MEMORIAL HEALTHCARE WILL COLLABORATE WITH AREA ORGANIZATIONS IN PROVIDING EDUCATION ON RESOURCES AND PROGRAMS AVAILABLE TO PATIENTS NEEDING FINANCIAL ASSISTANCE.IN ADDITION, WMH WILL WORK TO INFORM THE PUBLIC OF COMMUNITY RESOURCES, SUCH AS FOOD BANKS, THAT COULD BE USEFUL TO FAMILIES STRUGGLING WITH FINANCIAL STABILITY.VERNON MEMORIAL HEALTHCARE WILL IMPLEMENT THE FOLLOWING STRATEGIES TO INFORM THE PUBLIC OF RESOURCES: - FACEBOOK POSTS - PRINTED MATERIAL - WEBSITE LINKS- SOCIAL WORKER INTERACTIONCHILDCAREPER THE 2021 COMMUNITY HEALTHCARE NEEDS ASSESSMENT, 10% OF RHS RESPONDENTS AND 22% OF CS RESPONDENTS REPORT THEY ARE EITHER "MODERATELY CONCERNED OR "VERY CONCERNED" ABOUT ACCESS TO CHILDCARE.VERNON MEMORIAL HEALTHCARE WILL WORK WITH ECONOMIC, SCHOOL, AND CIVIC LEADERS TO ADDRESS THE NEED FOR CHILDCARE AND LEND SUPPORT. IN ADDITION, THROUGH PARTNERSHIPS WITH CHAMBERS OF COMMERCE, SCHOOL DISTRICTS, AND OTHER GROUPS, VERNON MEMORIAL HEALTHCARE WILL SUPPORT EFFORTS TO BRING ADDITIONAL CHILDCARE OPTIONS TO THE AREA. |
| VERNON MEMORIAL HEALTHCARE, INC. | PART V, SECTION B, LINE 13B: PATIENTS' RELIANCE ON MEDICARE OR MEDICAL ASSISTANCE. |
| VERNON MEMORIAL HEALTHCARE, INC. | PART V, SECTION B, LINE 13H: THE ORGANIZATION PROVIDES "CATASTROPHIC CARE" FOR PATIENTS NOT MEETING FINANCIAL ASSISTANCE ELIGIBILITY. THESE PATIENTS MAY BE ELIGIBLE FOR ASSISTANCE UNDER CIRCUMSTANCES WHEN MEDICAL BILLS WOULD RESULT IN SEVERE FINANCIAL HARDSHIP. PATIENTS, OR THEIR GUARANTORS, MAY BE ELIGIBLE FOR CATASTROPHIC CARE ASSISTANCE IF THEY INCURRED OUT-OF-POCKET OBLIGATIONS RESULTING FROM MEDICAL SERVICES PROVIDED BY VERNON MEMORIAL HEALTHCARE, INC. THAT EXCEED 25% OF THE ADJUSTED GROSS INCOME AND HAVE ASSETS BELOW THE EQUIVALENT OF 600% OF THE FPL THRESHOLD.IF A PATIENT HAS A BALANCE OF $500 OR MORE AND INCOME IS BELOW 100% FPG, THEY WILL QUALIFY FOR CATASTROPHIC CARE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 9 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - HIRSCH CLINIC | ||||
| 407 S MAIN ST SUITE 400 | VIROQUA | WI | 54665 | PROVIDER BASED RURAL HEALTH CLINIC |
| 2 - LAFARGE MEDICAL CLINIC | ||||
| 206 N MILL ST | LAFARGE | WI | 54639 | PROVIDER BASED RURAL HEALTH CLINIC |
| 3 - VERNON MEMORIAL HEALTHCARE PHARMACY | ||||
| 407 S MAIN ST SUITE 400 | VIROQUA | WI | 54665 | PHARMACY |
| 4 - BLAND CLINIC | ||||
| 100 MELBY ST | WESTBY | WI | 54667 | PROVIDER BASED RURAL HEALTH CLINIC |
| 5 - VERNON MEMORIAL PHARMACY - LAFARGE | ||||
| 206 N MILL STREET | LAFARGE | WI | 54639 | PHARMACY |
| 6 - SOLAR TOWN PHARMACY | ||||
| 104 SUNSET AVE | SOLDIERS GROVE | WI | 54655 | PHARMACY |
| 7 - KICKAPOO VALLEY MEDICAL CLINIC | ||||
| 102 SUNSET AVE | SOLDIERS GROVE | WI | 54655 | PROVIDER BASED RURAL HEALTH CLINIC |
| 8 - FAIR HAVEN | ||||
| 601 ARENA DRIVE | VIROQUA | WI | 54665 | ASSISTED LIVING |
| 9 - OLD TIMES | ||||
| 206 POLLY RUDE WAY | WESTBY | WI | 54667 | ASSISTED LIVING |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | CATASTROPHIC CARE: PATIENTS NOT MEETING FINANCIAL ASSISTANCE ELIGIBILITY THRESHOLDS MAY BE ELIGIBLE FOR ASSISTANCE UNDER CIRCUMSTANCES WHEN MEDICAL BILLS WOULD RESULT IN SEVERE FINANCIAL HARDSHIP. PATIENTS, OR THEIR GUARANTORS, MAY BE ELIGIBLE FOR CATASTROPHIC CARE ASSISTANCE IF THEY INCURRED OUT-OF-POCKET OBLIGATIONS RESULTING FROM MEDICAL SERVICES PROVIDED BY VERNON MEMORIAL HEALTHCARE, INC. THAT EXCEED 25% OF THE ADJUSTED GROSS INCOME AND HAVE ASSETS BELOW THE EQUIVALENT OF 600% OF THE FPL THRESHOLD.IF INCOME IS BELOW 100% FPG, THEY WILL QUALIFY FOR CATASTROPHIC CARE. |
| PART I, LINE 7: | THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS COSTING METHODS FOR THE FORM 990. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | OUR HOSPITAL PROVIDES CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. BUT IN ADDITION, WE BELIEVE THAT WE PROVIDE A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. OUR HOSPITAL, LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE LOCAL ACCESS TO MANY HEALTH SERVICES: BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES AND URGENT CARE, HOME CARE, HOSPICE, INFUSION SERVICES, INPATIENT CARE, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SPEECH AND AUDIOLOGY, SURGICAL SERVICES, AND WOMEN'S HEALTH. |
| PART III, LINE 4: | ACCOUNTS RECEIVABLE AND CREDIT POLICY:IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. |
| PART III, LINE 8: | VERNON MEMORIAL HEALTHCARE, INC. IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND AS SUCH A PORTION OF ITS REVENUES ARE PAID UNDER A COST REIMBURSEMENT SYSTEM. BASED ON THE INSTRUCTIONS, THE TOTAL MEDICARE REVENUE SHOWN ON THIS FORM 990 INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE THAT IS ACTUALLY RECEIVED BY THE HOSPITAL FROM THE MEDICARE PROGRAM. THE AMOUNTS LISTED FOR MEDICARE DO NOT INCLUDE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT METHODOLOGY AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT VERNON MEMORIAL HEALTHCARE, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREA. THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES WHICH THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THE RECIPIENTS ARE TYPICALLY ELDERLY AND/OR DISABLED MEMBERS OF THE COMMUNITY AND ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. |
| PART III, LINE 9B: | IN ORDER TO PROVIDE THE LEVEL OF AID NECESSARY TO THE GREATEST NUMBER OF PATIENTS IN NEED, AND PROTECT THE RESOURCES NEEDED TO DO SO, THE FOLLOWING GUIDELINES APPLY: 1) SERVICES ARE PROVIDED UNDER CHARITY CARE ONLY WHEN DEEMED MEDICALLY NECESSARY AND AFTER PATIENTS ARE FOUND TO HAVE MET ALL FINANCIAL CRITERIA BASED ON THE DISCLOSURE OF PROPER INFORMATION AND DOCUMENTATION. 2) CHARITY CARE IS NOT AVAILABLE FOR ELECTIVE PROCEDURES. 3) PATIENTS ARE EXPECTED TO CONTRIBUTE PAYMENT FOR CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION; THEREFORE, EACH CASE WILL BE REVIEWED SEPARATELY. 4) CHARITY CARE IS NOT CONSIDERED AN ALTERNATIVE OPTION FOR PAYMENT AND PATIENTS MAY BE ASSISTED IN FINDING OTHER MEANS OF PAYMENT OR FINANCIAL ASSISTANCE BEFORE APPROVAL FOR CHARITY CARE. 5) UNINSURED PATIENTS WHO ARE BELIEVED TO HAVE THE FINANCIAL ABILITY TO PURCHASE HEALTH INSURANCE MAY BE ENCOURAGED TO DO SO IN ORDER TO ENSURE HEALTHCARE ACCESSIBILITY AND OVERALL WELL-BEING. |
| PART VI, LINE 2: | IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED IN CONJUNCTION WITH AREA HEALTH CARE FACILITIES, THE GREAT RIVERS UNITED WAY AND COUNTY HEALTH DEPARTMENTS, VERNON MEMORIAL HEALTHCARE CONTINUALLY GATHERS AND REVIEWS DATA RELATED TO COMMUNITY NEEDS BY UTILIZING MORE INFORMAL FOCUS AND ADVISORY GROUPS, DISCUSSIONS WITH AREA EMPLOYERS, AS WELL AS THROUGH SERVING ON LOCAL AND STATE BOARDS AND COMMITTEES. THE ORGANIZATION COLLABORATES WITH COMMUNITY ORGANIZATIONS, CHURCHES, BUSINESSES, AGENCIES, AND LOCAL K-12 SCHOOLS, COLLEGES, AND UNIVERSITIES TO DETERMINE THE NEEDS OF THE COMMUNITIES SERVED. BOARD MEMBERS REPRESENT NOT ONLY THE CITY OF VIROQUA, BUT COME FROM THE DIFFERENT AREAS SERVED BY THE ORGANIZATION. THESE BOARD MEMBERS REGULARLY MEET WITH THE PEOPLE IN THEIR AREAS TO UTILIZE THE SERVICES OFFERED BY THE ORGANIZATION AND BRING BACK THEIR ISSUES AND CONCERNS. ADDITIONAL RESOURCES ADDED TO COLLECTING DATA AND UNDERSTANDING THE COMMUNITIES VERNON MEMORIAL HEALTHCARE SERVES ARE INSIGHT DATA COLLECTED ON SOCIAL MEDIA AND FOLLOWING ONLINE AREA TRENDS. INFORMATION HAS ALSO BEEN COLLECTED VIA PATIENT SURVEYS SENT TO PATIENTS POST-VISIT REGARDING THE CARE THEY RECEIVED. |
| PART VI, LINE 3: | VERNON MEMORIAL HEALTHCARE MAKES EVERY EFFORT TO EDUCATE PATIENTS ABOUT FINANCIAL ASSISTANCE AVAILABLE AT THE TIME OF REGISTRATION AND FOLLOWING DISCHARGE. REGISTRATION HAS A HARD STOP IN EPIC TO REMIND STAFF TO OFFER FINANCIAL ASSISTANCE TO THE PATIENTS. IF A PATIENT REFUSES FINANCIAL ASSISTANCE AT TIME OF REGISTRATION, IT IS DOCUMENTED. FORMS AND INSTRUCTIONS ARE AVAILABLE AT ALL REGISTRATION AREAS, INCLUDING THE MAIN ENTRANCE TO THE HOSPITAL, OUTPATIENT SERVICES, EMERGENCY ROOM, AND OUTLYING CLINICS. FINANCIAL COUNSELORS ARE AVAILABLE DURING DAYTIME HOURS TO ASSIST PATIENTS WITH THE COMPLETION OF FORMS, EITHER IN PERSON, OVER THE PHONE OR THROUGH MYCARE. INFORMATION ABOUT CHARITY CARE AND DISCOUNT PROGRAMS IS ALSO AVAILABLE ON THE ORGANIZATION'S WEBSITE. SIGNS AND PAMPHLETS REGARDING THE FINANCIAL ASSISTANCE PROGRAM ARE POSTED AT ALL REGISTRATION LOCATIONS. |
| PART VI, LINE 4: | VERNON MEMORIAL HEALTHCARE SERVES THE CITY OF VIROQUA AND THE SURROUNDING AREA. OTHER TOWNS IN THE PRIMARY SERVICE AREA INCLUDE WESTBY, READSTOWN, SOLDIERS GROVE, CASHTON, AND LAFARGE. THE SECONDARY SERVICE AREA EXTENDS TO THE CITIES OF DESOTO, FERRYVILLE, HILLSBORO, COON VALLEY, RICHLAND CENTER, GAYS MILLS, VIOLA, AND ONTARIO. THE COMMUNITIES AND SURROUNDING RURAL AREAS IN THE PRIMARY SERVICE HAVE AN APPROXIMATE POPULATION OF 28,000. THE SECONDARY SERVICE AREA INCLUDES AN ADDITIONAL 25,000 PERSONS. THE ENTIRE AREA IS RURAL WITH AN AGING POPULATION AND RELATIVELY LOW INCOME LEVELS. |
| PART VI, LINE 5: | VERNON MEMORIAL HEALTHCARE PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO THE PEOPLE IN THE COMMUNITIES IT SERVES. SERVICES ARE PROVIDED WITHOUT REGARD TO RACE, COLOR, CREED, RELIGION, GENDER ORIENTATION, DISABILITY, AGE, OR NATIONAL ORIGIN. VERNON MEMORIAL HEALTHCARE OPERATES A 24/7 EMERGENCY ROOM THAT IS OPEN TO SERVE ALL IN NEED, REGARDLESS OF ABILITY TO PAY. THE ORGANIZATION OWNS AND OPERATES FOUR RURAL HEALTH CLINICS LOCATED IN THE CITIES OF VIROQUA, WESTBY, SOLDIERS GROVE AND LAFARGE, AS WELL AS THREE RETAIL PHARMACIES LOCATED IN VIROQUA, LAFARGE, AND SOLDIERS GROVE. VERNON MEMORIAL HEALTHCARE COLLABORATES WITH COMMUNITIES, CHURCHES, BUSINESSES, AND OTHER HEALTH CARE ORGANIZATIONS IN THE REGION TO FACILITATE AND STRENGTHEN ACCESSIBILITY OF QUALITY COMPREHENSIVE HEALTHCARE SERVICES. THE ORGANIZATION SUPPORTS THE LOCAL COMMUNITIES BY PROVIDING CONVENIENT LOCATIONS FOR PRIMARY CARE AND PHARMACY SERVICES. THE BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY MEMBERS WHO REPRESENT THE MAKE-UP OF THE AREAS SERVED BY THE ORGANIZATION. VERNON MEMORIAL HEALTHCARE HAS AN OPEN MEDICAL STAFF MADE UP OF QUALIFIED PHYSICIANS WHO WORK WITH THE HOSPITAL TO PROVIDE CARE TO THE COMMUNITIES SERVED. ALL QUALIFIED PHYSICIANS AND AFFILIATED STAFF WHO ARE GRANTED PRIVILEGES UNDERGO A THOROUGH AND COMPREHENSIVE CREDENTIALING AND ORIENTATION PROCESS. ANY SURPLUS FUNDS GENERATED THROUGH OPERATIONS ARE USED TO CONTINUE TO MEET THE NEEDS OF THE PEOPLE THAT ARE SERVED THROUGH THE ADDITION OF NEW FACILITIES AND EQUIPMENT, OR THE ADDITION OR EXPANSION OF NEEDED SERVICES. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| RESTORING HOPE TRANSPLANT HOUSE | |||||||
| 7457 TERRACE AVE | MIDDLETON | WI | 53562 | 204786829 | 501(C)(3) | $15,000 | RENOVATION PROJECT |
| SMRT BUS (LA CROSSE COUNTY) | |||||||
| 212 6TH STREET NORTH ROOM 1300 | LA CROSSE | WI | 54601 | 396005709 | GOV'T ORGANIZATION | $10,000 | ANNUAL PLEDGE PAYMENT - PROGRAM MAINT |
| VIROQUA AREA FOUNDATION | |||||||
| PO BOX 262 | VIROQUA | WI | 54665 | 391603279 | 501(C)(3) | $10,000 | FIRE TRAINING TOWER PLEDGE PAYMENT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | CHARITABLE CONTRIBUTIONS MADE BY VERNON MEMORIAL HEALTHCARE (CMH) WILL BE LIMITED TO ELIGIBLE ORGANIZATIONS THAT SET FORWARD A FUNDING REQUEST THAT DEMONSTRATE AN ALIGNMENT WITH THE VMH MISSION, VMH VISION AND VALUES, AND/OR TARGETED TO SUPPORT A NEED SET FORWARD IN THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE COMMUNITIES SERVED BY VMN. ALL ELIGIBLE ORGANIZATIONS MUST BE RECOGNIZED AS A 501(C)(3) ENTITY BY THE INTERNAL REVENUE SERVICE. THE MARKETING MANAGER IS RESPONSIBLE FOR EVALUATION OF ALL APPLICATIONS TO DETERMINE ALIGNMENT WITH THIS POLICY AND TO ENSURE THAT VMH MAINTAINS APPROPRIATE OVERALL FISCAL CONTROL ON EXPENDITURE OF COMMUNITY SUPPORT FUNDS. IT IS HER/HIS INDIVIDUAL AUTHORITY TO DENY ANY REQUEST THAT DOES NOT MEET ESTABLISHED CRITERIA OR THAT IS NOT IN ALIGNMENT WITH THE VMH FISCAL NEEDS AND SHE/HE HAS FINAL AUTHORITY FOR THAT DECISION. FOR THOSE APPLICATIONS DEEMED TO MEET THE CRITERIA OF THIS POLICY, THE FOLLOWING TABLE HIGHLIGHTS AUTHORITY LIMITS: MARKETING MANAGER -$5,000 AND BELOW -AND ONE-TIME DONATION -AND TOTAL ANNUAL COMMITMENT REMAINS AT OR BELOW BUDGET CEO -$5,001 AND UP -AND ONE-TIME DONATION -AND TOTAL ANNUAL COMMITMENT REMAINS AT OR BELOW BUDGET BOARD OF DIRECTORS -DONATIONS CAUSE THE ENTITY TO EXCEED THE ANNUAL APPROVED BUDGET VALUE -AND/OR ALL MULTI-YEAR COMMITMENTS | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR BRIAN LYLE | ||||||||||||||
| PHYSICIAN | $482,648 | $0 | $0 | $0 | $0 | $0 | $7,040 | $0 | $7,319 | $0 | $497,007 | $0 | $0 | $0 |
| BRIAN MILLER | ||||||||||||||
| CRNA | $359,957 | $0 | $10,000 | $0 | $0 | $0 | $9,758 | $0 | $52,124 | $0 | $431,839 | $0 | $0 | $0 |
| DR ANDREW MANSPEAKER | ||||||||||||||
| ER PHYSICIAN | $373,135 | $0 | $0 | $0 | $0 | $0 | $8,979 | $0 | $22,419 | $0 | $404,533 | $0 | $0 | $0 |
| JEFFREY SCHEIDT | ||||||||||||||
| CRNA | $359,959 | $0 | $12,500 | $0 | $0 | $0 | $5,514 | $0 | $25,069 | $0 | $403,042 | $0 | $0 | $0 |
| DR ANTHONY MACASAET | ||||||||||||||
| ER PHYSICIAN | $356,106 | $0 | $0 | $0 | $0 | $0 | $8,912 | $0 | $16,536 | $0 | $381,554 | $0 | $0 | $0 |
| DAVID HARTBERG | ||||||||||||||
| CEO | $293,028 | $0 | $0 | $0 | $10,000 | $0 | $1,000 | $0 | $24,429 | $0 | $328,457 | $0 | $0 | $0 |
| KAREN TRAYNOR | ||||||||||||||
| CFO (THRU JULY) | $251,229 | $0 | $0 | $0 | $4,351 | $0 | $0 | $0 | $5,281 | $0 | $260,861 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 391337855 | BondIssuerEIN |
| CUSIP | 97712DGX8 | CUSIPNum |
| Bond Issued | 2014-12-09 | BondIssuedDt |
| Issue Price | $19,445,225 | IssuePriceAmt |
| Purpose | REFINANCE 2005 BONDS | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $4,485,225 | RetiredAmt |
| Total Proceeds | $19,445,225 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $286,481 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $19,158,744 | OtherSpentProceedsAmt |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | Yes (1) | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | DATE REBATE COMPUTATION PERFORMED | FormAndLineReferenceDesc |
| Explanation | ISSUER NAME: WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 12/09/2019 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | ANY PERSON WHO IS EIGHTEEN YEARS OF AGE OR OLDER AND A BONA FIDE RESIDENT OF VERNON COUNTY, WISCONSIN, OR THE AREA WITHIN A RADIUS OF TWENTY-FIVE MILES OF THE CITY OF VIROQUA, WISCONSIN, AND WHO HAS HERETOFORE OR MAY HEREAFTER CONTRIBUTE TEN DOLLARS OR MORE TO VERNON MEMORIAL HEALTHCARE, INC. (THE ORGANIZATION") SHALL BE A MEMBER THEREOF. ALL MEMBERS OF THE ORGANIZATION SHALL BE VOTING MEMBERS. EACH MEMBER SHALL HAVE ONE VOTE ON ANY MATTER SUBMITTED TO A VOTE OF THE MEMBERS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE DUTIES OF THE MEMBERS OF THE ORGANIZATION SHALL BE: THE ELECTION OF MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION, THE REMOVAL OF MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION, AND THE CHANGING OF THE NUMBER OF DIRECTORS CONSTITUTING THE BOARD OF DIRECTORS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE DUTIES OF THE MEMBERS OF THE VERNON ORGANIZATION SHALL ALSO INCLUDE: THE AMENDMENT, RESTATEMENT, OR MODIFICATION OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE ORGANIZATION; AND THE APPROVAL OF THE SALE, LEASE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL OF THE ASSETS AND PROPERTY OF THE ORGANIZATION, THE DISSOLUTION OF THE ORGANIZATION, OR ITS MERGER WITH ANOTHER CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS OF VERNON MEMORIAL HEALTHCARE, INC. FOR REVIEW AFTER FILING THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS OF VERNON MEMORIAL HEALTHCARE, INC. ARE REQUIRED TO DISCLOSE ALL POSSIBLE CONFLICTS OF INTEREST WHEN FIRST ELECTED TO THE BOARD OF DIRECTORS. DURING THEIR TERMS, IF ANY BUSINESS RELATIONSHIPS ARE ENTERED INTO WHICH MAY AFFECT THEIR INDEPENDENCE AS A MEMBER, THE MEMBER MUST IMMEDIATELY DISCLOSE THESE RELATIONSHIPS. |
| FORM 990, PART VI, SECTION B, LINE 15 | TO DETERMINE APPROPRIATE SALARY RANGES FOR UPPER MANAGEMENT POSITIONS, VERNON MEMORIAL HEALTHCARE, INC. UTILIZES BENCHMARK DATA FROM SURVEYS CONDUCTED BY RELEVANT TRADE ORGANIZATIONS. THE CEO HAS THE RIGHT TO AMEND THE DETERMINED AMOUNT FOR THE CFO. THE BOARD HAS THE RIGHT TO AMEND THE AMOUNT FOR THE CEO. A COMMITTEE OF THE BOARD REVIEWS THE DATA FOR THE CEO ANNUALLY TO DETERMINE THE AMOUNT OF HIS COMPENSATION AND ANY CHANGES IN COMPENSATION ARE MAINTAINED IN THE PERSONNEL FILE. |
| FORM 990, PART VI, SECTION C, LINE 19 | VERNON MEMORIAL HEALTHCARE, INC. MAKES ITS FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC ON A PER REQUEST BASIS. THE FORM 990 IS ALSO AVAILABLE TO THE PUBLIC ON A THIRD-PARTY WEBSITE CALLED GUIDESTAR. |
| FORM 990, PART XI, LINE 2C: | OVERSIGHT OF AUDIT: VERNON MEMORIAL HEALTHCARE, INC. DOES NOT HAVE A SPECIFIC COMMITTEE WHICH ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. THE ENTIRE BOARD OF DIRECTORS IS RESPONSIBLE FOR SELECTION OF THE INDEPENDENT ACCOUNTANT. NO CHANGES HAVE BEEN MADE IN THE PAST YEAR REGARDING THIS OVERSIGHT FUNCTION OF THE GOVERNING BODY. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VERNON MEMORIALGUNDERSEN LUTHERAN MEDICAL BUILDING CONDOMINIUM ASSOC LTD | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 507 S MAIN ST | AddressLine1Txt |
| City | VIROQUA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54665 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320182492 | EIN |
| Primary Activities | PROPERTY MANAGEMENT | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $167,481 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $9,442 | ShareOfEOYAssetsAmt |
| Ownership | 0.50000 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | 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 |