BURNETT MEDICAL CENTER INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- BURNETT MEDICAL CENTER INC (EIN 39-0938661)
- Tax period
- 2019-10-01 to 2020-09-30
- Filed
- 2021-08-11
- IRS object ID
- 202122239349300802
- Schema version
- 2019v5.2
- 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 J
- Schedule K
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-08-11T06:58:30-05:00 | ReturnTs |
| Tax Period End | 2020-09-30 | 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 | 2019-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390938661 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BURNETT MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BURN | BusinessNameControlTxt |
| Phone | 7154635353 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 257 WEST SAINT GEORGE AVENUE | AddressLine1Txt |
| City | GRANTSBURG | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54840 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GORDON LEWIS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7154635353 | PhoneNum |
| Signature | 2021-08-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2021-08-09 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GORDON LEWIS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 257 WEST SAINT GEORGE AVENUE | AddressLine1Txt |
| City | GRANTSBURG | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54840 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $22,113,058 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BURNETTMEDICALCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1956 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF BURNETT MEDICAL CENTER IS TO PROVIDE COMPASSIONATE, COMPREHENSIVE, COMMUNITY HEALTHCARE THAT EXCEEDS OUR CUSTOMER'S EXPECTATIONS. OUR MISSION, AS WELL AS OUR VISION AND VALUES, SERVES AS A GUIDELINE FOR DAILY DECISION MAKING AND REPRESENTS THE PRINCIPLES AND PRACTICES THAT WE CONSTANTLY APPLY. THE COMFORT AND CARE OF OUR PATIENTS IS A MAJOR FOCUS OF OURS. WE WANT TO BE THE HEALTHCARE PROVIDER OF "CHOICE" - PROVIDING EXPERT AND COST-EFFECTIVE CARE IN A "HOMETOWN" ATMOSPHERE.ANOTHER OBJECTIVE OF OURS IS TO PROVIDE EDUCATION THAT WILL INCREASE HEALTH AWARENESS. PART OF OUR MISSION IS TO CONTINUALLY PUT THE "CARE" IN HEALTHCARE. MORE HEALTHCARE INFORMATION IS NOW AVAILABLE FROM OUR WEBSITE, WHICH ALSO PROVIDES PATIENT EDUCATION RESOURCES FOR THOSE WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 280 | TotalEmployeeCnt |
| Total Volunteers | 19 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $31,433 | PYContributionsGrantsAmt |
| CY Contributions Grants | $333,131 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $21,482,101 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,521,780 | CYProgramServiceRevenueAmt |
| PY Investment Income | $56,579 | PYInvestmentIncomeAmt |
| CY Investment Income | $67,107 | CYInvestmentIncomeAmt |
| PY Other Revenue | $81,901 | PYOtherRevenueAmt |
| CY Other Revenue | $44,566 | CYOtherRevenueAmt |
| PY Total Revenue | $21,652,014 | PYTotalRevenueAmt |
| CY Total Revenue | $21,966,584 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,729,233 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,120,842 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,895,775 | PYOtherExpensesAmt |
| CY Other Expenses | $9,801,190 | CYOtherExpensesAmt |
| PY Total Expenses | $21,625,008 | PYTotalExpensesAmt |
| CY Total Expenses | $21,922,032 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $27,006 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $44,552 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,862,158 | TotalAssetsBOYAmt |
| Total Assets EOY | $27,385,708 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $13,548,349 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $22,824,549 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,313,809 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,561,159 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF BURNETT MEDICAL CENTER IS TO PROVIDE COMPASSIONATE, COMPREHENSIVE, COMMUNITY HEALTHCARE THAT EXCEEDS OUR CUSTOMER'S EXPECTATIONS. OUR MISSION, AS WELL AS OUR VISION AND VALUES, SERVES AS A GUIDELINE FOR DAILY DECISION MAKING AND REPRESENTS THE PRINCIPLES AND PRACTICES THAT WE CONSTANTLY APPLY. THE COMFORT AND CARE OF OUR PATIENTS IS A MAJOR FOCUS OF OURS. WE WANT TO BE THE HEALTHCARE PROVIDER OF "CHOICE" - PROVIDING EXPERT AND COST-EFFECTIVE CARE IN A "HOMETOWN" ATMOSPHERE.ANOTHER OBJECTIVE OF OURS IS TO PROVIDE EDUCATION THAT WILL INCREASE HEALTH AWARENESS. PART OF OUR MISSION IS TO CONTINUALLY PUT THE "CARE" IN HEALTHCARE. MORE HEALTHCARE INFORMATION IS NOW AVAILABLE FROM OUR WEBSITE, WHICH ALSO PROVIDES PATIENT EDUCATION RESOURCES FOR THOSE WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $11,488,850 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $15,559,824 | RevenueAmt |
| Desc | HOSPITAL - BURNETT MEDICAL CENTER, LOCATED IN RURAL NORTHWEST WISCONSIN IS A 17-BED CRITICAL ACCESS HOSPITAL THAT PROVIDES THE FOLLOWING SERVICES THROUGHOUT A THREE-COUNTY REGION:ACUTE CARE HAS 50+ EMPLOYEES WHO ALSO WORK IN OR, ER, AND PAR. WE PROVIDE GENERAL INPATIENT MEDICAL AND SURGICAL CARE, AS WELL AS A LARGE VOLUME OF OUTPATIENT SERVICES WHICH INCLUDE: OP SURGERY, CHEMOTHERAPY, BLOOD TRANSFUSION, IV THERAPY AS EXAMPLES. ALL OF THE RN STAFF IS ACLS ACCREDITED AND THE ENTIRE STAFF IS CERTIFIED IN CPR. THE GOAL OF THE NURSING STAFF IS TO PROVIDE EXCELLENT PATIENT CARE, CLOSE TO HOME, NEAR FAMILY AND FRIENDS. WE ALSO PROVIDE A FULL RANGE OF SERVICES FROM A 24/7 ER TO CARDIAC REHAB, AND WE PROVIDE OTHER THERAPEUTIC AND DIAGNOSTIC SERVICES VIA RADIOLOGY, LAB, PHYSICAL THERAPY, AND OCCUPATIONAL THERAPY.DURING FY2020, IN A TOTAL OF 873 PATIENT DAYS WE SERVED 198 PATIENTS IN OUR INPATIENT AND SWING BED PROGRAMS. WE PERFORMED 288 SURGICAL PROCEDURES, SAW 3,214 PATIENTS IN EMERGENCY AND URGENT CARE, AND PROVIDED SERVICES FOR 11,483 OTHER OUTPATIENT VISITS. GROSS HOSPITAL REVENUE OF $74,660 WAS PROVIDED AS CHARITY CARE TO 33 DIFFERENT PATIENTS FOR 123 EPISODES OF CARE.SINCE JUNE OF 2004, BURNETT MEDICAL CENTER HAS BEEN PARTICIPATING IN A PROGRAM DEVELOPED BY ABBOTT NORTHWESTERN HOSPITAL AND THE MINNEAPOLIS HEART INSTITUTE. THE LEVEL 1 HEART ATTACK PROGRAM IS AN INNOVATIVE APPROACH TO TREATING PATIENTS SUFFERING FROM A HEART ATTACK. THE KEY INGREDIENT FOR SUCCESS IS SPEED IN TREATMENT. THE GOAL IS TO TREAT AND TRANSPORT PATIENTS WITHIN 120 MINUTES, MEANING 120 MINUTES FROM THE TIME A PATIENT ENTERS THE EMERGENCY ROOM AT BURNETT MEDICAL CENTER UNTIL THE FIRST BALLOON IS INFLATED OR STENT PLACED AT ABBOTT NORTHWESTERN HOSPITAL (ABNW).BECAUSE RURAL HOSPITALS DO NOT HAVE THE CAPABILITY TO DO ANGIOPLASTY, IT IS IMPORTANT TO MOVE A HEART ATTACK PATIENT TO THE NEAREST HOSPITAL THAT HAS A HEART CATHETERIZATION LAB. THE LEVEL 1 PROGRAM HAS A DEFINITE PROTOCOL TO MOVE THESE PATIENTS QUICKLY DURING THAT "GOLDEN HOUR" WHEN ANGIOPLASTY IS THE MOST SUCCESSFUL.BURNETT MEDICAL CENTER IS ONE OF 30 HOSPITALS IN MINNESOTA AND WISCONSIN PARTICIPATING IN THE LEVEL 1 PROGRAM. CLEARLY, THE LEVEL 1 PROGRAM IS ADVANTAGEOUS TO RESIDENTS OF BURNETT COUNTY, KNOWING THAT CARDIOVASCULAR DISEASE IS THE LEADING CAUSE OF DEATH FOR MEN AND WOMEN IN THE US. THIS TEAM APPROACH GIVES PATIENTS THE ADVANTAGE OF TIME WHICH TRANSLATES TO BETTER OUTCOMES AND DECREASED MORTALITY. BURNETT MEDICAL CENTER'S MEDICAL AND NURSING STAFF HAVE BEEN TRAINED FOR THIS PROGRAM AND ARE PREPARED AND PLEASED TO PROVIDE QUICK ACCESS TO EFFICIENT CARDIAC CARE THROUGH THE LEVEL 1 HEART ATTACK PROGRAM. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,530,980 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,504,129 | RevenueAmt |
| Desc | CLINIC - BURNETT MEDICAL CENTER CLINIC IS LOCATED JUST OFF HIGHWAY 70 IN GRANTSBURG AND IS PART OF OUR EXPANDED FACILITY. THE CLINIC IS STAFFED BY 20 EMPLOYEES INCLUDING (3) PHYSICIANS, (3) CERTIFIED NURSE PRACTITIONERS, AND (1) CERTIFIED NURSE MIDWIFE. SERVED SPECIALISTS INCLUDING A GENERAL SURGEON, A PULMONOLOGIST, AN INTERNAL MEDICINE PHYSICIAN AND OTHERS ALL SEE PATIENTS IN THE CLINIC.WE ARE PLEASED TO OFFER OUR PATIENTS A RANGE OF SERVICES INCLUDING: PHYSICALS (INCLUDING WELL CHILD CHECKS, PRE-OPERATIVE, DOT, ETC.), OBSTETRICAL EXAMS, HEALTH STATUS ASSESSMENTS, DIAGNOSIS AND TREATMENT OF COMMON, ACUTE AND CHRONIC HEALTH CONDITIONS, IMMUNIZATIONS, FAMILY PLANNING, DIABETIC EDUCATION, WOMEN'S HEALTH, COLONOSCOPY PROCEDURES, FRACTURE CARE, VASECTOMIES, ROUTINE LABORATORY TESTING, EKG'S, AND HOLTER MONITORING. ADDITIONALLY, THE CLINIC LABORATORY IS A CERTIFIED COLLECTION SITE FOR URINE DRUG SCREENING.HOURS OF OPERATION HAVE BEEN EXPANDED TO ALLOW PEOPLE INCREASED ACCESS, INCLUDING WORKING FAMILIES WITH SCHOOL-AGE CHILDREN, PEOPLE THAT WORK VARYING SHIFTS, ETC. OUR PROVIDERS HAVE COLLABORATIVE RELATIONSHIPS WITH AREA INDUSTRIES, INCLUDING THE LOCAL SCHOOL SYSTEMS. THIS ALLOWS BURNETT MEDICAL CENTER TO PROVIDE EDUCATIONAL OPPORTUNITIES TO EMPLOYEES OF THESE INDUSTRIES, INCLUDING BLOODBORNE PATHOGENS TRAINING, HEALTH EDUCATION TO SCHOOL CHILDREN, AND PARTICIPATION IN EMPLOYEE HEALTH FAIRS. BMC PROVIDERS PARTICIPATE IN THE LOCAL ROTARY GROUP AND IN COUNTY COALITIONS TO REDUCE PRESCRIPTION DRUG ABUSE AND IMPROVE AWARENESS OF WELLNESS ACTIVITIES IN THE AREA. WE ALSO SPONSOR AN ANNUAL 5K/10K, AND KID-FRIENDLY 100-YARD EVENT THAT RAISES FUNDS FOR A LOCAL CHARITY WHILE PROMOTING HEALTHY LIFESTYLES. THIS YEAR IS OUR 14TH ANNUAL!OVER 12,200 PRIMARY CARE CLINIC VISITS WERE PROVIDED DURING FY 2020. CLINIC GROSS REVENUE OF $5,472 WAS PROVIDED AS CHARITY CARE TO 19 DIFFERENT PATIENTS IN 79 VISITS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,191,272 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,457,827 | RevenueAmt |
| Desc | CONTINUING CARE - THE CONTINUING CARE CENTER OF BURNETT MEDICAL CENTER OFFERS 46 SEMI-PRIVATE AND 4 PRIVATE ROOM ACCOMMODATIONS AND A FULL RANGE OF HEALTH AND PERSONAL CARE SERVICES. PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY ARE AVAILABLE, AS WELL AS NUTRITIONAL SERVICES, RECREATIONAL ACTIVITIES, AND SOCIAL SERVICES. ADDITIONALLY, ADULT DAY CARE AND RESPITE CARE IS AVAILABLE.THE GOAL OF THE CONTINUING CARE CENTER'S STAFF IS TO PROVIDE NECESSARY HEALTH SERVICES WHILE MAINTAINING AN ATMOSPHERE OF HOPE, HARMONY, HUMOR, AND A "HOME" AWAY FROM HOME.WE STRIVE TO ENHANCE THE QUALITY OF RESIDENTS' LIFE VIA A VENUE FOR COMMUNITY-BASED VOLUNTEERS SHARING THEIR TIME AND TALENT WITH OUR RESIDENTS, SUCH AS MUSICAL BANDS, ROTARY CLUB SPONSORED FUNCTIONS, ETC. DURING FY 2020 WE HAD 16,519 RESIDENT DAYS SERVING ABOUT 98 DIFFERENT RESIDENTS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $18,211,102 | 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 | 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 | 0 | 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 | 9 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 280 | 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GORDON LEWIS | PersonNm |
| Phone | 7154635353 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 257 WEST SAINT GEORGE AVE | AddressLine1Txt |
| City | GRANTSBURG | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54840 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| TIMOTHY NOVICK | |||||||
| PHYSICIAN | 40.00 | Yes (X) | $293,719 | $0 | $33,459 | ||
| DAVID LANG MD | |||||||
| PHYSICIAN | 36.00 | Yes (X) | $196,800 | $0 | $28,619 | ||
| LINAE HICKS | |||||||
| NURSE PRACTITIONER | 40.00 | Yes (X) | $159,462 | $0 | $26,400 | ||
| JULIE ANDERSON | |||||||
| PHYSICIAN'S ASSISTANT | 40.00 | Yes (X) | $152,227 | $0 | $25,169 | ||
| MELINDA DEYE | |||||||
| NURSE PRACTITIONER | 40.00 | Yes (X) | $160,569 | $0 | $1,996 | ||
| GORDON LEWIS | |||||||
| CEO | 40.00 | $166,875 | $0 | $2,442 | Yes (X) | ||
| GORDON FORBORT | |||||||
| CFO | 40.00 | $105,400 | $0 | $0 | Yes (X) | ||
| PATRICK TAYLOR | |||||||
| PRESIDENT | 0.50 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| RYAN BENSON | |||||||
| VICE PRESIDENT | 0.50 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| JULIE FIEDLER | |||||||
| SECRETARY/TREASURER | 0.50 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| RANDY CAREY | |||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| DAN DOWLING | |||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| KATIE HOLLEY | |||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| CHRIS SYBERS | |||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,235,052 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $118,085 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 16 | 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 |
|---|---|---|---|---|---|
| MEADOWS ANESTHESIA ASSOCIATES INC | |||||
| 10513 STONEBRIDGE TRAIL N | STILLWATER | MN | 55082 | ANESTHESIA | $553,601 |
| WIPFLI LLP | |||||
| PO BOX 3160 | MILWAUKEE | WI | 53201 | AUDIT/IT SERVICES | $262,109 |
| BLAISE VIATLE MD SC | |||||
| 22592 ASSEMBLY DRIVE | GRANTSBURG | WI | 54840 | MD ER/CLINIC | $223,076 |
| SURGERY CLINIC OF SPOONER | |||||
| N6142 LITTLE VL ROAD | SPOONER | WI | 54801 | GENERAL SURGEON | $170,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $312,457 | GovernmentGrantsAmt |
| All Other Contributions | $20,674 | AllOtherContributionsAmt |
| Total Contributions | $333,131 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOSPITAL PATIENT SERVICE REVENUE | 621990 | $15,559,824 | $15,559,824 |
| NURSING HOME RESIDENT SERVICE REV | 623000 | $3,457,827 | $3,457,827 |
| CLINIC PATIENT SERVICE REVNUE | 621110 | $2,504,129 | $2,504,129 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,521,780 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,466 | TotalRevenueColumnAmt |
| Exclusion | $61,466 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $15,362 | 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 | $15,362 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,362 | TotalRevenueColumnAmt |
| Exclusion | $15,362 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $152,115 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $146,474 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,641 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,641 | TotalRevenueColumnAmt |
| Exclusion | $5,641 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $17,829 | TotalRevenueColumnAmt |
| Exclusion | $17,829 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,375 | TotalRevenueColumnAmt |
| Exclusion | $11,375 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $29,204 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,966,584 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,521,780 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $111,673 | 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 | $274,717 | TotalAmt |
| Management And General | $274,717 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,261,384 | TotalAmt |
| Program Services | $7,847,959 | ProgramServicesAmt |
| Management And General | $1,413,425 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,921,437 | TotalAmt |
| Program Services | $1,583,706 | ProgramServicesAmt |
| Management And General | $337,731 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $663,304 | TotalAmt |
| Program Services | $546,021 | ProgramServicesAmt |
| Management And General | $117,283 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,176 | TotalAmt |
| Management And General | $18,176 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,350 | TotalAmt |
| Management And General | $62,350 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,671 | TotalAmt |
| Management And General | $6,671 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,753,064 | TotalAmt |
| Program Services | $3,237,268 | ProgramServicesAmt |
| Management And General | $515,796 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,331 | TotalAmt |
| Management And General | $66,331 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,142 | TotalAmt |
| Program Services | $75,697 | ProgramServicesAmt |
| Management And General | $154,445 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,128 | TotalAmt |
| Management And General | $141,128 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,984 | TotalAmt |
| Program Services | $314,984 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,501 | TotalAmt |
| Program Services | $46,959 | ProgramServicesAmt |
| Management And General | $16,542 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $270,151 | TotalAmt |
| Program Services | $218,311 | ProgramServicesAmt |
| Management And General | $51,840 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $830,333 | TotalAmt |
| Program Services | $679,076 | ProgramServicesAmt |
| Management And General | $151,257 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,185 | TotalAmt |
| Management And General | $88,185 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $1,473,988 | $1,473,988 | |
| MEDICAL SUPPLIES | $1,379,148 | $1,378,706 | $442 |
| REPAIRS & MAINTENANCE | $673,290 | $547,505 | $125,785 |
| MINOR EQUIPMENT | $246,389 | $238,207 | $8,182 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,359 | TotalAmt |
| Program Services | $22,715 | ProgramServicesAmt |
| Management And General | $160,644 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,922,032 | TotalAmt |
| Program Services | $18,211,102 | ProgramServicesAmt |
| Management And General | $3,710,930 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,555,403 | BOYAmt |
| EOY | $11,862,894 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,154,270 | BOYAmt |
| EOY | $3,488,454 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $304,579 | BOYAmt |
| EOY | $292,164 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $124,527 | BOYAmt |
| EOY | $109,135 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $28,461,441 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $19,996,030 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,868,362 | BOYAmt |
| EOY | $8,465,411 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,687,308 | BOYAmt |
| EOY | $2,817,736 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,709 | BOYAmt |
| EOY | $349,914 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,862,158 | BOYAmt |
| EOY | $27,385,708 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,877,679 | BOYAmt |
| EOY | $1,751,390 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $4,007,312 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,147,797 | BOYAmt |
| EOY | $10,389,304 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $522,873 | BOYAmt |
| EOY | $6,676,543 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,548,349 | BOYAmt |
| EOY | $22,824,549 | 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 | $4,299,511 | BOYAmt |
| EOY | $4,545,563 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,298 | BOYAmt |
| EOY | $15,596 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,313,809 | BOYAmt |
| EOY | $4,561,159 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,862,158 | BOYAmt |
| EOY | $27,385,708 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $44,552 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $35,519 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $167,279 | 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 | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule 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 | $3,384 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,384 | 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 | BURNETT MEDICAL CENTER, INC. PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND DEVELOPMENT. THE AHA AND WHA HAVE NOTIFIED BURNETT MEDICAL CENTER, INC. THAT $3,384 ($2,332 TO AHA AND $1,052 TO WHA) 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 | $50,000 | OtherCostOrOtherBasisAmt |
| Book Value | $50,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,165,211 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,401,510 | DepreciationAmt |
| Book Value | $7,763,701 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,128,621 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,594,520 | DepreciationAmt |
| Book Value | $534,101 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $117,609 | OtherCostOrOtherBasisAmt |
| Book Value | $117,609 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,465,411 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| 457(B) PLAN PAYABLE | $567,788 |
| SMALL BUSINESS ASSOCIATION - PAYROLL PROTECTION PROGRAM | $2,061,100 |
| HEALTH AND HUMAN SERVICES ACCELERATED AND ADVANCED PAYMENT PROGRAM | $4,047,655 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,676,543 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $20,684,976 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $192,380 | OtherRevenueAmt |
| Revenue Not Reported | $192,380 | RevenueNotReportedAmt |
| Revenue Subtotal | $20,492,596 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,473,988 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,473,988 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $21,966,584 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $20,448,044 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $20,448,044 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,473,988 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,473,988 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $21,922,032 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CMDI EQUITY GAINS 156,861. UNREALIZED GAIN 35,519. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 1,473,988. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 1,473,988. |
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 | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| 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 | $44,476 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $44,476 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,562,621 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,837,417 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $725,204 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03310 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,607,097 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,837,417 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $769,680 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03510 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,824,179 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,390,531 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,433,648 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06540 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,936 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,936 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,828,115 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,390,531 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,437,584 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06560 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,435,212 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,227,948 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,207,264 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10070 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $818,112 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $409,056 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $5,886,762 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,729,330 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $157,432 | 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 | BURNETT MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 257 WEST SAINT GEORGE AVENUE | AddressLine1Txt |
| City | GRANTSBURG | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54840 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 1034 | 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 | BURNETT MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | 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 SUPPLEMENTAL INFORMATION | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE SUPPLEMENTAL INFORMATION | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SUPPLEMENTAL INFORMATION | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, PAGE 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, PAGE 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, PAGE 8 | 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 |
| Other Publicity | Yes (X) | OtherPublicityInd |
| 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 Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BURNETT MEDICAL CENTER, INC. | PART V, SECTION B, LINE 5: THROUGHOUT THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS, EFFORTS WERE MADE TO ENGAGE AND GATHER INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SERVED. THIS WAS ACCOMPLISHED IN THE FOLLOWING CAPACITIES:1. CHNA CORE PARTNERS: AS THE PRIMARY DRIVERS OF THE PROCESS, FACILITATORS OF THE CHNA FROM BURNETT MEDICAL CENTER AND BURNETT COUNTY DHHS-PUBLIC HEALTH, EACH BROUGHT KNOWLEDGE OF THEIR POPULATION SERVED, THEIR NEEDS, AND RESOURCES CURRENTLY AVAILABLE TO ADDRESS THOSE NEEDS. CORE PARTNERS ARE ALSO ACTIVELY INVOLVED IN OTHER COMMUNITY HEALTH-RELATED GROUPS AND CONVEYED INPUT REGARDING THE HEALTH NEEDS OF THE GROUPS' RESPECTIVE TARGET POPULATIONS THROUGHOUT THE PROCESS.2. SURVEY: THE SURVEY WAS AVAILABLE TO THE PUBLIC FOR ABOUT 2 MONTHS AND WAS DISTRIBUTED TO 20 DIFFERENT LOCATIONS ACROSS BURNETT COUNTY. THE SURVEY ASKED RESPONDENTS TO IDENTIFY WHAT THEY PERCEIVED TO BE THE THREE BIGGEST HEALTH PROBLEMS AND RISKY BEHAVIORS AMONG BURNETT COUNTY RESIDENTS (SEE APPENDIX FOR RESULTS). DEMOGRAPHIC QUESTIONS ABOUT INCOME, INSURANCE TYPE, AND RACE/ETHNICITY, AMONG OTHERS WERE ALSO ASKED IN ORDER TO IDENTIFY MEMBERS OF DIFFERENT POPULATIONS AND THUS ENSURE THEIR REPRESENTATION. 3. COMMUNITY HEALTH FORUM: TWO COMMUNITY HEALTH FORUMS TOOK PLACE OVER TWO DAYS. THE FORUM CONSISTED OF A DATA PRESENTATION AND GROUP DISCUSSIONS TO DETERMINE THE NEXT STEPS TO BE TAKEN IN ORDER TO IMPROVE THE TOP THREE HEALTH NEEDS IN BURNETT COUNTY. THERE WERE GOOD DISCUSSIONS ON WHAT THE COMMUNITY WANTS TO DO TO IMPROVE. EDUCATION AND COMMUNITY INVOLVEMENT WERE BROUGHT UP FOR ALL THREE HEALTH NEEDS. INPUT WAS GATHERED FROM PUBLIC HEALTH REPRESENTATIVES, NOTFORPROFIT ORGANIZATION PROFESSIONALS, AND OTHER INDIVIDUALS WHO SERVE UNDERSERVED GROUPS. |
| BURNETT MEDICAL CENTER, INC. | PART V, SECTION B, LINE 6B: BURNETT COUNTY DHHS-PUBLIC HEALTH |
| BURNETT MEDICAL CENTER, INC. | PART V, SECTION B, LINE 11: IN RESPONSE TO THE REQUIREMENTS UNDER THE AFFORDABLE CARE ACT, BURNETT MEDICAL CENTER, IN PARTNERSHIP WITH THE BURNETT COUNTY DHHS-PUBLIC HEALTH, JOINTLY CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WHICH HAS BEEN HIGHLIGHTED IN OUR PREVIOUS 990, SCHEDULE H SUBMISSIONS. AS A RESULT OF THIS PARTNERSHIP, WE, ALONG WITH MANY PUBLIC AND PRIVATE HEALTHCARE INTERESTS, WORK COLLABORATIVELY VIA THE FORMATION OF HEALTHY BURNETT, AN ENTERPRISE THAT SEEKS AND WELCOMES OTHER COMMUNITY MEMBERS AND ORGANIZATIONS TO WORK TOGETHER IN ADDRESSING THE MOST COMPELLING NEEDS IDENTIFIED VIA THE CHNA. WHILE 990HS ARE DUE ON AN ANNUAL BASIS, WE ARE STILL IN THE CURRENT CHNA THREE-YEAR PERIOD. AS ONE MAY SURMISE, THE UNPRECEDENTED GLOBAL PANDEMIC REQUIRED ALL HANDS ON DECK TO ADDRESS THE CATACLYSMIC IMPACT OF COVID 19, AT THE EXPENSE OF OTHER IDENTIFIED AND COMPELLING COMMUNITY CHALLENGES. ACCORDINGLY, BURNETT MEDICAL CENTER'S INVOLVEMENT AND COMMITMENT TO THE IDENTIFIED ISSUES REMAIN, TO WIT:. ALCOHOL AND OTHER DRUG ABUSE (AODA): BURNETT MEDICAL CENTER (BMC) SEEKS TO IMPROVE ACCESS TO COUNSELING BY KEEPING AN UPDATED LIST OF AODA COUNSELING SERVICES AND COLLABORATING WITH AODA STAKEHOLDERS TO ASSIST THE COMMUNITY IN EARLY REFERRAL AND POTENTIAL TREATMENT. BMC WILL ALSO PROVIDE EDUCATION AND PROMOTION OF CURRENT RESOURCES THROUGH EVENTS AND USE OF SOCIAL MEDIA.BEHAVIORAL HEALTH: BURNETT MEDICAL CENTER (BMC) WILL IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES BY WORKING TOWARDS OFFERING ADULT PSYCHIATRIC SERVICES VIA TELEMEDICINE WITH THE POTENTIAL OF ADDING PEDIATRIC/ADOLESCENT TELEPSYCHIATRY SERVICES IN FUTURE. BMC WILL PROMOTE AWARENESS OF BEHAVIORAL HEALTH SERVICES BY HAVING THE "BEHAVIORAL HEALTH PROVIDERS" BROCHURES READILY AVAILABLE THROUGHOUT THE FACILITY AS WELL AS THRU EVENTS AND USE OF SOCIAL MEDIA.TOBACCO USE AND EXPOSURE: BURNETT MEDICAL CENTER (BMC) WILL EDUCATE PATIENTS ON THE IMPORTANCE OF TOBACCO ABSTINENCE/CESSATION THROUGH COUNSELING AND PROMOTION OF THE WISCONSIN TOBACCO QUIT LINE. BMC WILL PROVIDE EDUCATION TO COMMUNITY ADOLESCENTS ON THE IMPORTANCE OF TOBACCO ABSTINENCE AT AN AGE-APPROPRIATE LEVEL.EXAMPLES OF SUCCESS INCLUDE PARTNERING PARTNER WITH COMMUNITY PUBLIC HEALTH BY EDUCATING GRADE SCHOOL STUDENTS ON THE DANGERS OF TOBACCO, DRUG AND ALCOHOL USE. REGARDING BEHAVIORAL HEALTH, BMC WAS ENGAGED IN A COUNTY-WIDE EFFORT TO EDUCATE STUDENTS REGARDING SUICIDE PREVENTION AND THEIR ROLE IN SHARING THEIR CONCERNS OF PEERS WITH ADULTS.AS REQUIRED, BMC AND OUR PARTNERS WITH HEALTHY BURNETT ARE FOCUSED ON RE-CONVENING TO PLAN, STUDY, IDENTIFY AND ADJUST THE CONTINUING AND NEW OPPORTUNITIES ASSUMING WE WILL NOT BE PRECLUDED BY A CONTINUATION OF ANY FUTURE COVID RESTRICTIONS THAT MAY ARISE, THUS PRECLUDING THE REQUISITE INFORMATION GATHERING AND CONSENSUS BUILDING, WHICH HAS BEEN OUR HALLMARK.IN CLOSING, PLEASE KNOW THAT BURNETT MEDICAL CENTER IS THE SOLE HOSPITAL IN BURNETT COUNTY (880 SQUARE MILES). WE ARE A 17-BED, RURAL CRITICAL ACCESS HOSPITAL, COMBINED WITH AN EMPLOYED PROVIDER RURAL HEALTH CLINIC, 24/7 EMERGENCY DEPARTMENT, AND A 50-BED LONG-TERM CARE CENTER. AS SUCH, WE TAKE OUR MISSION SERIOUSLY, AND REMAIN-EVER FOCUSED ON OUR DAILY CALLING OF PROVIDING QUALITY, COMPASSIONATE CARE. MINDFUL OF OUR MISSION--WE, LIKE FEDERAL, STATE AND LOCAL GOVERNMENT--MUST BALANCE THE MANY COMPELLING AND COMPETING NEEDS, WITHIN A SEVERELY CONSTRAINED RESOURCE ENVIRONMENT. THERE IS GREAT NEED AMONG THOSE WE SERVE. WE ACKNOWLEDGE THE MANY COMPETING HEALTH ISSUES INHERENT IN SERVING A POPULATION THAT HAS LESS FINANCIAL RESOURCES, THAT IS OLDER, AND IS MORE GEOGRAPHICALLY DISPERSED THAN THAT OF EITHER THE STATE OR THE NATION.WE ARE ACUTELY AWARE AND RECOGNIZE THAT THERE ARE MANY OTHER COMPELLING HEALTHCARE ISSUES. WHILE WE CAN AND DO IDENTIFY THESE NEEDS, WE ARE FORCED TO PRIORITIZE THE MOST NEEDED AND COMPELLING AS DETERMINED BY OUR CHNA PROCESS, AND WITHIN THE LIMITED RESOURCES AVAILABLE IN A POOR, RURAL COUNTY. BE ASSURED THAT AS RESOURCES AND GRANT-FUNDING MAY BECOME AVAILABLE, BURNETT MEDICAL CENTER, IN PARTNERSHIP WITH OUR HEALTHY BURNETT CONSORTIUM, WILL CONTINUE TO ALLOCATE TIME, TALENT, AND RESOURCES TO THE SIGNIFICANT HEALTH NEEDS THAT HAVE BEEN CAPTURED IN OUR CONSENSUS-BUILDING CHNA PROCESS. |
| BURNETT MEDICAL CENTER, INC. | PART V, SECTION B, LINE 13H: HOMELESSNESS IS ALSO A DETERMINATION FACTOR. |
| BURNETT MEDICAL CENTER, INC. | PART V, SECTION B, LINE 16J: REGISTRATION AND CLINIC PERSONNEL OFTEN REFER UNINSURED AND LOW-INCOME INDIVIDUALS TO A FINANCIAL COUNSELOR TO DISCUSS THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY. |
| PART V, SECTION B, LINE 7A | HTTPS://J9Q55N0YFI38AIM2249RFJ19-WPENGINE.NETDNA-SSL.COM/WP-CONTENT/UPLOADS/2020/06/COMMUNITY_HEALTH_NEEDS_ASSESSMENT_2019.PDF |
| PART V, SECTION B, LINE 7B | HTTP://HEALTHYBURNETT.ORG/WP-CONTENT/UPLOADS/2019/10/BMC-CHNA-AND-IMPLEMENTATION-STRATEGY-2019.PDF |
| PART V, SECTION B, LINE 10 | HTTP://HEALTHYBURNETT.ORG/WP-CONTENT/UPLOADS/2019/10/BMC-CHNA-AND-IMPLEMENTATION-STRATEGY-2019.PDF |
| PART V, SECTION B, LINE 16A | FAP: HTTPS://WWW.BURNETTMEDICALCENTER.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/FINANCIAL-COLLECTION-POLICY-SUMMARY/ |
| PART V, SECTION B, LINE 16B | FAP APPLICATION: HTTPS://J9Q55N0YFI38AIM2249RFJ19-WPENGINE.NETDNA-SSL.COM/WP-CONTENT/UPLOADS/2020/07/ATTACHMENT-E-APPLICATION.PDF |
| PART V, SECTION B, LINE 16C | FAP PLAIN LANGUAGE SUMMARY: HTTPS://J9Q55N0YFI38AIM2249RFJ19-WPENGINE.NETDNA-SSL.COM/WP-CONTENT/UPLOADS/2020/07/ATTACHMENT-D-PLAIN-LANGUAGE-SUMMARY.PDF |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - THE CONTINUING CARE CENTER OF BURNETT | ||||
| MEDICAL CENTER 257 W ST GEORGE AVE | GRANSTBURG | WI | 54840 | SKILLED NURSING FACILITY |
| 2 - BURNETT MEDICAL CENTER CLINIC | ||||
| 257 W ST GEORGE AVE | GRANTSBURG | WI | 54840 | PROVIDER BASED RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 MEDICAL CENTER'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS COSTING METHODS FOR THE FORM 990. |
| PART I, LINE 7G: | THE COST OF SUBSIDIZED SERVICES IS BASED ON COST ALLOCATIONS FROM THE MEDICARE COST REPORT. ALLOWABLE COSTS ARE ASSIGNED DIRECTLY TO DEPARTMENTS THROUGHOUT THE YEAR AND THEN THE COST REPORT USES THE ALLOCATION METHODOLOGY TO ASSIGN ALL OTHER COSTS TO CALCULATE SERVICE LINE COSTS. SUBSIDIZED HEALTH SERVICES INCLUDE THE OPERATION OF THE CLINIC. THESE SERVICES ARE UNAVAILABLE TO MEMBERS OF THE COMMUNITY OTHER THAN THROUGH BURNETT MEDICAL CENTER, INC. IT HAS BEEN THE GOAL OF BURNETT MEDICAL CENTER, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | WE ARE CLOSE TO THE COMMUNITIES WE SERVE AND TAKE AN ACTIVE ROLE IN ADDRESSING THE ROOT FACTORS CONTRIBUTING TO OUR COMMUNITY'S HEALTH STATUS. WE DO SO THROUGH OUR INVOLVEMENT IN COMMUNITY-BUILDING PARTNERSHIPS THAT ADDRESS ECONOMIC DEVELOPMENT AND COMMUNITY HEALTH IMPROVEMENT ISSUES.THE ORGANIZATION'S CEO SERVES AS A BOARD MEMBER OF THE GRANTSBURG INDUSTRIAL DEVELOPMENT CORPORATION (GIDC) AS WELL AS THE BURNETT COUNTY DEVELOPMENT ASSOCIATION (BDCA). THESE ORGANIZATIONAL ENTERPRISES SEEK TO ENCOURAGE ECONOMIC GROWTH IN BURNETT MEDICAL CENTER'S PRIMARY SERVICE AREA. GIDC AND BDCA HAVE A STRONG HISTORY OF BRINGING NEW INDUSTRY INTO THE AREA WHICH RESULTS IN INCREASED EMPLOYMENT OPPORTUNITIES AND STRENGTHENS THE LOCAL ECONOMY. KNOWING THAT UNEMPLOYMENT LEADS TO AN INCREASE IN UNHEALTHY BEHAVIORS-WHICH IN TURN CAN LEAD TO INCREASED RISK FOR DISEASE OR MORTALITY-GIDC'S AND BDCA'S MISSION OF ENCOURAGING ECONOMIC GROWTH FAVORABLE AND DIRECTLY IMPACTS THE HEALTH OF BURNETT MEDICAL CENTER'S SERVICE AREA.FURTHERMORE, THE ORGANIZATION CONTINUES TO COLLABORATE WITH A LOCAL ADVOCACY GROUP, CITIZENS AGAINST POVERTY, WHICH SEEKS TO ELIMINATE BARRIERS CONTRIBUTING TO HIGH RATES OF POVERTY AMONG SERVICE AREA RESIDENTS. FOR EXAMPLE, HAVING IDENTIFIED LACK OF ACCESS TO TRANSPORTATION AS A ROOT CAUSE OF POVERTY, ONE AREA OF FOCUS HAS BEEN TO ADVOCATE FOR A MEANS OF PUBLIC TRANSPORTATION IN THE SERVICE AREA. DUE TO THE RURAL NATURE OF THE COMMUNITIES SERVED BY BURNETT MEDICAL CENTER, PROVIDING A MEANS OF TRANSPORTATION FOR RESIDENTS PROMOTES HEALTH BY INCREASING ACCESS TO JOB OPPORTUNITIES, TO GROCERY STORES AND FOOD SHELVES, AND TO HEALTHCARE SERVICES. HUNGER AND LACK OF ACCESS TO HEALTHY FOODS WAS IDENTIFIED AS ANOTHER ROOT CAUSE OF POVERTY. CITIZENS AGAINST POVERTY HAS UNDERTAKEN AN EFFORT TO ESTABLISH SUSTAINABLE SOURCES OF FOOD FOR AREA RESIDENTS BY PROVIDING SUPPLIES TO THEM AT NO COST TO CREATE RAISED BED GARDENS SO THEY ARE ABLE TO GROW THEIR OWN PRODUCE. |
| PART III, LINE 2: | THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE MEDICAL CENTER'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE FISCAL YEAR TO ESTIMATE THE COST OF THE CHARITY CARE OF PATIENTS THAT HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE MEDICAL CENTER ALSO PROVIDES DISCOUNTS TO ELIGIBLE UNINSURED OR UNDERINSURED PATIENTS UNDER ITS CHARITY CARE POLICY. THESE AMOUNTS ARE INCLUDED IN THE CONTRACTUAL ADJUSTMENTS ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED OR UNDERINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL. |
| PART III, LINE 3: | MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. MANY TIMES PATIENTS ARE UNABLE TO COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES. EVEN THOUGH THE HOSPITAL PROVIDES THIS INFORMATION TO ALL PATIENTS, A SMALL AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARTIY CARE. |
| PART III, LINE 4: | PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE MEDICAL CENTER 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 MEDICAL CENTER 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 AMOUNTSDUE 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 MEDICAL CENTER 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 AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. |
| PART III, LINE 8: | BURNETT MEDICAL CENTER, INC. IS DESIGNATED A CRITICAL ACCESS HOSPITAL AND AS SUCH A PORTION OF ITS REVENUE IS PAID UNDER A COST REIMBURSEMENT SYSTEM. BASED ON THE INSTRUCTIONS, THE TOTAL MEDICARE REVENUE SHOWN ON THIS FORM 990 INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE THAT IS ACTUALLY RECEIVED BY THE MEDICAL CENTER FROM THE MEDICARE PROGRAM. THE AMOUNTS LISTED FOR MEDICARE DO NOT INCLUDE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT BURNETT MEDICAL CENTER, INC. 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 BURNETT MEDICAL CENTER, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREA OF GRANTSBURG, WISCONSIN. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL MEDICAL CENTER PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES WHICH THE MEDICAL CENTER WOULD SHOW A LARGE LOSS ON THESE SERVICES. WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO 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: | PATIENTS RECEIVE OUR COMMUNITY CARE APPLICATION WHEN THEY PRESENT FOR SERVICES. THEY ARE ENCOURAGED TO REVIEW THE APPLICATION AND SUBMIT THE REQUIRED INFORMATION TO APPLY FOR POTENTIAL COVERAGE. IF THEY HAVE QUESTIONS OR NEED HELP WITH THE APPLICATION THEY MAY MEET WITH OUR FINANCIAL COUNSELOR AND/OR OUR BUSINESS OFFICE MANAGER. |
| PART VI, LINE 2: | WE CONTINUE TO RELY ON MARKETING AND DEMOGRAPHIC DATA FOR BOTH OUR PRIMARY AND SECONDARY SERVICE AREAS AS SUPPLIED BY PROPRIETARY SOURCES FROM TRUVEN ANALYTICS AND THE WISCONSIN HOSPITAL ASSOCIATION. SUCH MARKET-BASED ANALYSIS PROVIDES EVIDENCE-BASED ESTIMATES AND PROJECTIONS FOR THE MEDICAL NEEDS OF THOSE THAT LIVE WITHIN OUR SERVICE AREA. WE THEN ASSESS THE AVAILABILITY OF EXISTING HEALTHCARE PROVIDERS AND SERVICES TO DETERMINE WHAT GAPS MAY EXIST, AND HOW WE CAN BEST ALIGN OUR SERVICES IN ORDER TO BE ENGAGED IN THE ABILITY TO ADDRESS UNMET NEED IN PARTNERSHIP WITH BOTH PUBLIC AND PRIVATE PROVIDERS OF HEALTHCARE SERVICES. THE RESULT OF OUR REVIEW AND ANALYSIS SERVES AS A FUNDAMENTAL BASIS FOR THE DEVELOPMENT OF GOALS AND OBJECTIVES IN OUR STRATEGIC PLAN.FURTHERMORE, AS REQUIRED BY LAW, WE CONDUCT AND COMPLETE, ONCE EVERY THREE YEARS, A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AS REQUIRED UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, AND RELY ON OUR FINDINGS TO DETERMINE ANY NEEDED CHANGES OR CHALLENGES IN OUR FOCUS. IN CONDUCTING THE CHNA, A COMPREHENSIVE HEALTH NEEDS ASSESSMENT, USING BOTH QUANTITATIVE AND QUALITATIVE DATA, IS PERFORMED IN COLLABORATION WITH TWO KEY COMMUNITY PARTNERS: BURNET COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES-PUBLIC HEALTH.QUANTITATIVE DATA SOURCES INCLUDING THE COUNTY HEALTH RANKINGS, THE UNITED STATES CENSUS BUREAU, THE WISCONSIN DEPARTMENT OF HEALTH SERVICES, WISCONSIN INTERACTIVE STATISTICS ON HEALTH, AND THE BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM WERE RELIED UPON AND USED TO ASSESS THE HEALTH NEEDS OF THE SERVICE AREA BY COMPARING COUNTY-LEVEL DATA FOR GIVEN INDICATORS OF HEALTH TO STATE AND NATIONAL BENCHMARKS. WE INTEGRATED THIS QUANTITATIVE DATA WITH THE QUALITATIVE DATA THAT WAS GATHERED FROM COMMUNITY MEMBERS AND ORGANIZATIONS TO DEVELOP A BETTER UNDERSTANDING OF COMMUNITY PERCEPTIONS OF THE SERVICE AREA'S HEALTH NEEDS. THIS DATA IS GATHERED THROUGH (1) AN INTERNET-BASED SURVEY AND PAPER SURVEY OF APPROXIMATELY 500 INDIVIDUALS, (2) FOCUS GROUPS, AND (3) A KEY INFORMANT INTERVIEW.AFTER DATA IS COLLECTED, CHNA PARTNERS FACILITATE A COMMUNITY FORUM IN WHICH REPRESENTATIVES OF OTHER HEALTHCARE PROVIDERS, COMMUNITY GROUPS, AND LOCAL NON-PROFIT ORGANIZATIONS THAT HAVE AN INTEREST AND EXPERTISE IN THE HEALTH OF SERVICE AREA RESIDENTS ARE INVITED TO OFFER ADDITIONAL INPUT ON THE HEALTH NEEDS OF THE COMMUNITIES SERVED AND HELP PRIORITIZE THE IDENTIFIED NEEDS.THE RESULTS OF THE ASSESSMENT AND COMMUNITY FORUM ARE USED ALONG WITH KNOWLEDGE OF EXISTING ASSETS AVAILABLE TO MEET IDENTIFIED HEALTH NEEDS IN DEVELOPING AN IMPLEMENTATION STRATEGY THAT DELINEATES HOW BURNETT MEDICAL CENTER WILL TARGET EXISTING PROGRAMS AND RESOURCES, TARGET AND DEPLOY ANY AVAILABLE ADDITIONAL RESOURCES, AND COLLABORATE WITH OTHER COMMUNITY ENTITIES TO ADDRESS THE IDENTIFIED HEALTH NEEDS. FURTHERMORE, BURNETT MEDICAL CENTER HAS TAKEN A LEAD ROLE IN FORMULATING A COMMUNITY-WIDE PLAN TO ADDRESS THE TOP HEALTH NEED IDENTIFIED THROUGH THE CHNA. THE PLAN IS BEING EXECUTED BY THE COMMUNITY COLLABORATIVE "HEALTHY BURNETT" THAT WAS CREATED AS A RESULT OF THE CHNA TO ADDRESS THE IDENTIFIED HEALTH NEEDS. |
| PART VI, LINE 3: | PATIENTS ARE TOLD ABOUT OUR COMMUNITY CARE PROGRAM BY OUR FINANCIAL COUNSELOR, REGISTRATION STAFF , PATIENT ACCOUNT REPRESENTATIVES AND BUSINESS OFFICE MANAGER. IN ADDITION, WE HAVE SIGNS POSTED BY BOTH OUR CLINIC AND ER REGISTRATION AREAS INFORMING OUR PATIENTS OF THE COMMUNITY CARE PROGRAM AVAILABLE AT OUR FACILITY. IF THE PATIENT FEELS THEY WILL NEED ASSISTANCE WITH THEIR MEDICAL BILLS, THEY ARE ENCOURAGED TO APPLY FOR THE COMMUNITY CARE PROGRAM WITH ALL THE REQUIRED INFORMATION. FINALLY, PATIENTS ALSO HAVE ACCESS TO THE COMMUNITY CARE APPLICATION INFORMATION ON OUR WEBSITE, FOR EASIER ACCESS FOR OUR PATIENTS.WHILE WE DO NOT HAVE ANY CERTIFIED APPLICATION COUNSELORS, WE ARE CHARTER MEMBERS THAT JOINED THE FEDERAL GOVERNMENT'S CHAMPIONS FOR COVERAGE CAMPAIGN TO HELP EDUCATE PEOPLE ABOUT AND TO PROMOTE THE HEALTH INSURANCE MARKETPLACE. AS A CHAMPION FOR COVERAGE, WE HAVE UNDERTAKEN INITIATIVES TO DIRECT PEOPLE TO THE MARKETPLACE, INCLUDING SENDING OUR PATIENTS TO THE OFFICIAL CONSUMER SOURCES (HEALTHCARE.GOV WEBSITE AND CONSUMER CALL CENTER) TO LEARN ABOUT THE MARKETPLACE AND GET COVERAGE, HANGING POSTERS AND FACT SHEETS IN OUR FACILITY, INCLUDING AN ARTICLE ABOUT THE MARKETPLACE IN OUR QUARTERLY COMMUNITY NEWSLETTER, AND HAVING STAFF LEARN ABOUT THE MARKETPLACE IN EDUCATION SESSIONS. WE HAVE ALSO PARTICIPATED IN A COUNTY-WIDE EDUCATION SESSION ON THE NEW HEALTHCARE EXCHANGE AND HAVE WILLINGLY PROVIDED POSITIVE, RESPONSIVE ANSWERS TO MEDIA INQUIRIES. |
| PART VI, LINE 4: | LOCATED IN RURAL, NORTHWESTERN WISCONSIN, BURNETT COUNTY IS 880 SQUARE MILES WITH 18.8 CITIZENS PER SQUARE MILE (COMPARED TO THE WISCONSIN AVERAGE OF 105 CITIZENS PER SQUARE MILE). ANOTHER WAY OF REALIZING THE SIZE OF BURNETT COUNTY IS EVIDENCED BY THE FACT THAT, THE COUNTY'S LAND MASS WOULD ACCOUNT FOR OVER 85% OF THE ENTIRE LAND MASS OF THE STATE OF RHODE ISLAND (WHICH HAS A POPULATION DENSITY OF OVER 1,000 CITIZENS PER MILE).BURNETT COUNTY IS THE PRIMARY SERVICE AREA FOR BURNETT MEDICAL CENTER (BMC) AND BMC IS THE SOLE HOSPITAL IN BURNETT COUNTY. WHILE BURNETT MEDICAL CENTER IS A 17 BED FEDERALLY DESIGNATED CRITICAL ACCESS HOSPITAL, IT ALSO HAS A 50 BED LONG TERM CARE CENTER, AS WELL AS A PRIMARY CARE CLINIC. FURTHERMORE, BURNETT COUNTY IS A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA/POPULATION (ID NUMBER 03764), HAVING BEEN SO DESIGNATED ON JUNE 28, 1984.NOT LIMITED TO SERVING JUST BURNETT COUNTY, BURNETT MEDICAL CENTER ALSO PROVIDES CARE FOR RESIDENTS IN VARYING DEGREES TO RESIDENTS LIVING IN ONE OF THE FOUR ADJOINING WISCONSIN COUNTIES (DOUGLAS, WASHBURN, POLK, AND BARRON) AS WELL AS TWO ADJOINING COUNTIES IN MINNESOTA (PINE AND CHISAGO). BOTH BURNETT COUNTY IN WISCONSIN AND PINE COUNTY IN MINNESOTA ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS, AND THE REMAINING COUNTIES AFOREMENTIONED, HAVE AREAS WITHIN THEIR COUNTIES DESIGNATED AS MEDICALLY UNDERSERVED AS WELL.DEMOGRAPHICALLY, BASED ON THE MOST CURRENTLY AVAILABLE US CENSUS DATA, THE 2016 ESTIMATES FOR BURNETT COUNTY REFLECT A POPULATION OF 15,159 WHICH IS A SLIGHT DECREASE FROM THE 2015 CENSUS RESULTS, OR A 1.9% DECREASE WHEN COMPARED TO THE 2010 CENSUS RESULTS.BURNETT COUNTY IS ONE OF WISCONSIN'S POORER COUNTIES APPROACHING NEARLY ONE IN FIVE PERSONS (16.5%) LIVING BELOW THE POVERTY LEVEL COMPARED TO THE STATE AVERAGE AND A MEDIAN INCOME WHICH IS WELL BELOW THE STATE MEDIAN INCOME. DEMOGRAPHICALLY OUR OVER 65 YEAR OLD POPULATION REPRESENTS MORE THAN ONE IN FOUR, OR 26.3% OF THE POPULATION, AND AGAIN WELL ABOVE THE WISCONSIN STATE AVERAGE OF 15.2%.ACCORDING TO THE US CENSUS DATA FROM JULY 2015, WHILE THE COUNTY POPULATION IS COMPRISED OF PREDOMINATELY WHITE PERSONS AT 91.85%, OUR NEXT LARGEST POPULATION IS AMERICAN INDIAN AT 4.7% (COMPARED TO 1.1% OVERALL FOR THE STATE).THERE ARE SIMILARITIES IN OUR SECONDARY SERVICE AREAS. FOR INSTANCE, IN THE NEIGHBORING COUNTIES OF POLK COUNTY IN WISCONSIN AND PINE COUNTY IN MINNESOTA, BASED ON CENSUS BUREAU DATA, THEIR COMPARISONS SHOW THEY TOO HAVE FAR FEWER PERSONS PER SQUARE MILE, ARE RELATIVELY LOWER THAN THEIR RESPECTIVE STATE AVERAGES FOR MEDIAN HOUSEHOLD INCOME, AND RELATIVELY HIGHER IN THE 65+ YEARS OF AGE POPULATION, AS WELL AS HAVING GREATER THAN STATE AVERAGE OF BOTH WHITE PERSONS AND AMERICAN INDIANS.DESPITE OUR RURAL LOCATION IN NORTHWEST WISCONSIN, WE ARE IN A RELATIVELY COMPETITIVE MARKET AS RESIDENTS FROM BOTH OUR PRIMARY AND SECONDARY SERVICE AREAS HAVE ACCESS TO TEN HOSPITALS (IN EITHER WISCONSIN OR MINNESOTA) WITHIN 50 MILES OF BURNETT MEDICAL CENTER'S GEOGRAPHIC LOCATION IN GRANTSBURG, WISCONSIN. AS STATED PREVIOUSLY, BURNETT MEDICAL CENTER OPERATES AN EMPLOYED-PROVIDER MEDICAL CLINIC WHICH IS ONE OF MANY COMPETITOR CLINICS WITHIN OUR PRIMARY AND SECONDARY MARKETS.FINALLY, WE TAKE OUR ROLE AS A VITAL PART OF A NECESSARY HEALTH CARE SAFETY NET FOR ALL SERIOUSLY, INCLUDING THE UNINSURED, AS EVIDENCED BY OUR 24/7 EMERGENCY DEPARTMENT WHICH PROVIDES EMERGENT, URGENT, AND PRIMARY CARE TO ALL THAT PRESENT TO THE EMERGENCY DEPARTMENT. WE STAND READY AS, WITH PRIDE, WE ARE ACUTELY AWARE OF OUR MISSION OF SERVICE TO EVERY PATIENT, EVERY MINUTE, OF EVERY DAY. |
| PART VI, LINE 5: | AS A SOLE COMMUNITY RURAL HOSPITAL WE TAKE PRIDE IN BEING CLOSE TO THOSE WE SERVE. WE SHARE WITH THE COMMUNITY VIA PRINT, SOCIAL, AND ONLINE MEDIA OUTLETS RELEVANT AND HELPFUL KNOWLEDGE OF OUR SERVICES, AS WELL AS EDUCATIONAL INFORMATION ON VARIOUS HEALTH TOPICS. WE ALSO SHARE AND PROMOTE OUR MISSION THROUGHOUT THE COMMUNITIES SERVED. WE LEARN DIRECTLY FROM THOSE WE SERVE BY OUR BOARD OF DIRECTORS GOVERNING STRUCTURE WHICH IS COMPOSED OF SEVEN UNCOMPENSATED COMMUNITY VOLUNTEERS FROM THROUGHOUT BURNETT COUNTY, THAT RESIDE IN EITHER OUR PRIMARY OR SECONDARY SERVICE AREA, NONE OF WHICH ARE NEITHER EMPLOYEES, CONTRACTORS, NOR FAMILY MEMBERS.WE ENJOY THE CONTINUED SUPPORT OF OUR COMMUNITY VIA A HEALTHCARE FOUNDATION, WHICH PROVIDES PHILANTHROPIC SUPPORT TO FULFILLING THE HOSPITAL'S MISSION.IN ORDER TO ENSURE CONTINUED AND READY ACCESS TO QUALIFIED HEALTHCARE PROVIDERS, WE TAKE PRIDE IN HAVING AN OPEN MEDICAL STAFF MODEL THAT EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PROVIDERS IN OUR COMMUNITY.WHEN WE HAVE SURPLUS FUNDS, THOSE FUNDS, COMBINED WITH OUR LOCAL FOUNDATION AND OTHER GRANTS OBTAINED THROUGH COMPETITIVE PROCESSES, ARE USED FOR IMPROVEMENTS IN PATIENT CARE AND QUALITY, AS EVIDENCED BY THE PURCHASE OF NEW AND NEEDED CAPITAL EQUIPMENT. WE ALSO HAVE CONTINUED INVESTMENTS AS AN EARLY ADOPTER OF THE ELECTRONIC MEDICAL RECORD AND WE REMAIN FOCUSED ON ACHIEVING THE GOALS OF FEDERALLY-ESTABLISHED MEANINGFUL USE GUIDELINES AND EXPECTATIONS.ADVOCACY OF THE COMMUNITIES HEALTHCARE NEEDS ARE DONE LOCALLY BY MEMBERS OF THE BOARD SPEAKING WITH LOCAL OFFICIALS ON RELEVANT ISSUES THAT MAY AFFECT THE HOSPITAL. ADDITIONALLY, THE ORGANIZATION'S CEO CONTINUES TO SERVE AS A MEMBER OF THE WISCONSIN HOSPITAL ASSOCIATION'S PUBLIC POLICY COUNCIL, AS WELL AS A MEMBER OF THE HOSPITAL ASSOCIATION'S NETWORK ADEQUACY TASK FORCE, AND TELEMEDICINE TASK FORCE IN SUPPORT OF THE ASSOCIATION'S MISSION AND STRATEGIC PLAN THAT EMPHASIZES ADVOCACY FOR INITIATIVES FOR COMMUNITY, STATE AND NATIONAL EFFORTS FOR IMPROVING THE OVERALL HEALTH OF THE POPULATION AND CONTINUED READY ACCESS TO QUALITY HEALTHCARE FOR ALL.FINALLY, MINDFUL OF THE NEED FOR SUPPORT OF VARIOUS METHODS OF INSURANCE, WE ARE PROUD OF OUR PARTICIPATION IN SUCH GOVERNMENTALLY-SPONSORED HEALTHCARE PROGRAMS SUCH AS MEDICARE, MEDICAID, AND TRICARE, ALL OF WHICH HAVE AN INCREASED FOCUS ON THE PROVISION OF VALUED BASED SERVICES, TO INCLUDE AN INCREASED EMPHASIS ON PREVENTATIVE CARE SERVICES. SUCH SERVICES FOCUS ON THE EARLY DETECTION AND INTERVENTION(S) WHICH ARE DESIGNED TO PREVENT OR DELAY THE HARMFUL ASPECTS MORE CHRONIC HEALTH CONDITIONS, SUCH AS DIABETES AND CONGESTIVE HEART FAILURE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIMOTHY NOVICK | ||||||||||||||
| PHYSICIAN | $292,579 | $0 | $0 | $0 | $1,140 | $0 | $0 | $0 | $33,459 | $0 | $327,178 | $0 | $0 | $0 |
| DAVID LANG MD | ||||||||||||||
| PHYSICIAN | $195,612 | $0 | $0 | $0 | $1,188 | $0 | $0 | $0 | $28,619 | $0 | $225,419 | $0 | $0 | $0 |
| LINAE HICKS | ||||||||||||||
| NURSE PRACTITIONER | $159,250 | $0 | $0 | $0 | $212 | $0 | $0 | $0 | $26,400 | $0 | $185,862 | $0 | $0 | $0 |
| JULIE ANDERSON | ||||||||||||||
| PHYSICIAN'S ASSISTANT | $151,773 | $0 | $0 | $0 | $454 | $0 | $0 | $0 | $25,169 | $0 | $177,396 | $0 | $0 | $0 |
| MELINDA DEYE | ||||||||||||||
| NURSE PRACTITIONER | $160,023 | $0 | $0 | $0 | $546 | $0 | $0 | $0 | $1,996 | $0 | $162,565 | $0 | $0 | $0 |
| GORDON LEWIS | ||||||||||||||
| CEO | $165,798 | $0 | $0 | $0 | $1,077 | $0 | $0 | $0 | $2,442 | $0 | $169,317 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| BURNETT COUNTY | |||||||
| A | 396005675 | 2007-03-23 | $7,000,000 | TO REFINANCE AND PROVIDE FUNDS FOR BUILDING RENOVATION AND EXPANSION | 0 | 0 | 0 |
| VILLAGE OF GRANTSBURG | |||||||
| B | 396006277 | 2007-04-10 | $5,000,000 | TO PROVIDE FUNDS FOR BUILDING RENOVATION AND EXPANSION | 0 | 0 | 0 |
| VILLAGE OF SIREN | |||||||
| C | 396008452 | 2007-04-25 | $4,850,000 | TO PROVIDE FUNDS FOR BUILDING RENOVATION AND EXPANSION | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | $2,691,134 | $7,000,000 | $140,000 | $5,464,764 | $1,395,236 | 2008 | Yes (1) | 0 | Yes (1) | Yes (1) |
| B | $1,913,482 | $5,000,000 | $100,000 | $4,900,000 | 2008 | 0 | 0 | Yes (1) | Yes (1) | |
| C | $1,856,080 | $4,850,000 | $97,000 | $4,753,000 | 2008 | 0 | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| C | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 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 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 |
| C | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
| C | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | EACH PERSON, BUSINESS, CORPORATION, OR ORGANIZATION WHO HAS CONTRIBUTED AND PAID ONE HUNDRED DOLLARS OR MORE TO BURNETT MEDICAL CENTER, INC. "THE MEDICAL CENTER" SHALL BE A LIFETIME MEMBER OF THE MEDICAL CENTER. EACH PERSON, BUSINESS, CORPORATION, OR ORGANIZATION IS ENTITLED TO HOLD A MAXIMUM OF ONE MEMBERSHIP CERTIFICATE. A HUSBAND AND WIFE, OR TWO OR MORE RELATED PERSONS, MAY HOLD A MEMBERSHIP AS JOINT TENANTS, HOWEVER, ONLY ONE VOTE PER MEMBERSHIP SHALL BE PERMITTED. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE DUTIES OF THE MEMBERS OF THE MEDICAL CENTER SHALL BE: THE FORMULATION AND DEVELOPMENT OF THE OVERALL PURPOSES, OBJECTIVES, AND PHILOSOPHY OF THE MEDICAL CENTER; THE ELECTION OF MEMBERS OF THE BOARD OF DIRECTORS OF THE MEDICAL CENTER; THE REMOVAL OF MEMBERS OF THE BOARD OF DIRECTORS OF THE MEDICAL CENTER; THE CHANGING OF THE NUMBER OF DIRECTORS CONSTITUTING THE BOARD OF DIRECTORS; THE AMENDMENT, RESTATEMENT, OR MODIFICATION OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE MEDICAL CENTER; AND THE APPROVAL OF THE SALE, LEASE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL OF THE ASSETS AND PROPERTY OF THE MEDICAL CENTER OR ITS MERGER WITH ANOTHER CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD OF DIRECTORS FOR BURNETT MEDICAL CENTER, INC. REVIEWS FORM 990 PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | BURNETT MEDICAL CENTER, INC. HAS A CONFLICT OF INTEREST POLICY. THE PURPOSE OF THIS POLICY IS TO PROTECT THE INTEREST OF THE MEDICAL CENTER WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE CORPORATION. IT IS EXPECTED THAT SUCH PERSONS SHALL EXERCISE THE UTMOST GOOD FAITH IN ALL TRANSACTIONS TOUCHING UPON THEIR DUTIES AT BURNETT MEDICAL CENTER, INC. AND ITS PROPERTY. ALL MEMBERS OF THE BOARD COMPLETE A DISCLOSURE FORM UPON APPOINTMENT, AND REVIEW AND SIGN IT ANNUALLY THEREAFTER. THIS STATEMENT ESTABLISHES THE DUTY OF AN INTERESTED PARTY TO DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST DISCLOSE ALL MATERIAL FACTS. AFTER ANY SUCH DISCLOSURE, HE/SHE SHALL LEAVE THE GOVERNING BOARD MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON BY THE REMAINING BOARD MEMBERS. IF THE BOARD HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS OF SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF MEMBERS FAIL TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | BURNETT MEDICAL CENTER INC.'S EXECUTIVE COMPENSATION POLICY IS DESIGNED WITH THE GOAL OF PROVIDING REMUNERATION THAT IS FAIR, REASONABLE, AND COMPETITIVE. THE MEDICAL CENTER'S BOARD MAY ESTABLISH A COMPENSATION COMMITTEE OR MAY ACT AS A COMMITTEE OF THE WHOLE IN EXECUTIVE SESSION. THE COMMITTEE OVERSEES THE TOTAL COMPENSATION PACKAGES TO ENSURE THAT THEY ARE COMPETITIVE WITH OTHER HEALTHCARE ORGANIZATIONS, REFLECT JOB RESPONSIBILITIES AND REQUIREMENTS, AND ARE FAIR, EQUITABLE, AND CONSISTENTLY MANAGED. THE COMMITTEE MEETS AS OFTEN AS IT DEEMS APPROPRIATE TO CARRY OUT ITS RESPONSIBILITIES. IN GENERAL, THE MEDICAL CENTER POSITIONS TOTAL EXECUTIVE COMPENSATION AT THE MEDIAN OF THE MARKET. THE BOARD OF DIRECTORS USES CONTEMPORANEOUS DATA INCLUDING EXECUTIVE COMPENSATION DATA FROM THE WISCONSIN HOSPITAL ASSOCIATION AS A GUIDE WHEN APPROVING THE COMPENSATION OF THE ADMINISTRATOR AND CHIEF FINANCIAL OFFICER. THE POLICY IS MEANT TO BE FLEXIBLE SO THAT COMPENSATION CAN BE ABOVE OR BELOW THE MEDIAN BASED ON EXPERIENCE, PERFORMANCE, SIZE AND COMPLEXITY OF ORGANIZATION, AND BUSINESS NEED TO ATTRACT AND RETAIN EXECUTIVE TALENT. |
| FORM 990, PART VI, SECTION C, LINE 19 | BURNETT MEDICAL CENTER, INC. MAKES IT FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC ON A PER REQUEST BASIS. |
| FORM 990, PART IX, LINE 11G | RADIOLOGY SERVICES: PROGRAM SERVICE EXPENSES 419,841. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 419,841. ANESTHESIOLOGY CONTRACT LABOR: PROGRAM SERVICE EXPENSES 551,287. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 551,287. CLINIC PURCHASED SERVICES AND CONTRACT LABOR: PROGRAM SERVICE EXPENSES 591,783. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 591,783. LAUNDRY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 200,816. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 200,816. DIETARY PURCHASED SERVICES AND CONTRACT LABOR: PROGRAM SERVICE EXPENSES 364,110. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 364,110. EMERGENCY CONTRACT LABOR: PROGRAM SERVICE EXPENSES 295,983. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 295,983. MEDICAL AND ADMIN PURCHASED SERVICES AND CONTRACT LABOR: PROGRAM SERVICE EXPENSES 813,448. MANAGEMENT AND GENERAL EXPENSES 515,796. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,329,244. |
| FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 10,418. CHANGE IN INVESTMENT IN UNCONSOLIDATED AFFILIATE 156,861. |
| FORM 990, PART XII, LINE 2C: | OVERSIGHT OF THE AUDIT: BURNETT MEDICAL CENTER, INC. DOES NOT HAVE A SPECIFIC COMMITTEE WHICH ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. THE ENTIRE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |