STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

BELLIN MEMORIAL HOSPITAL INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
BELLIN MEMORIAL HOSPITAL INC (EIN 39-0884478)
Tax period
2019-10-01 to 2020-09-30
Filed
2021-08-11
IRS object ID
202122239349301302
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 ReturnHeader

FieldValueIRS element (for citing)
Return2021-08-11T11:10:17-05:00ReturnTs
Tax Period End2020-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 12237AddressLine1Txt
CityGREEN BAYCityNm
State AbbreviationWIStateAbbreviationCd
ZIP543072237ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390884478EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BELLIN MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBELLBusinessNameControlTxt
Phone9204457260PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 23400AddressLine1Txt
CityGREEN BAYCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54305ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJAMES DIETSCHEPersonNm
Person TitleEVP-CFOPersonTitleTxt
Phone9204457260PhoneNum
Signature2021-08-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTERRI REXRODE CPA MSTPreparerPersonNm
PTINP00096513PTIN
Phone9206620016PhoneNum
Preparation2021-08-10PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJAMES DIETSCHEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 23400AddressLine1Txt
CityGREEN BAYCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54305ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$607,967,223GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BELLIN.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1908FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionBELLIN MEMORIAL HOSPITAL, INC. (BMH) PROVIDES HEALTH CARE SERVICES AND OTHER FINANCIAL SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER MATTERS, TO ENHANCE THE HEALTH OF THE COMMUNITY AND IMPROVE THE HEALTH OF LOW-INCOME PATIENTS. CONSISTENT WITH THE MISSION OF BMH, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION, BMH PROVIDES SERVICES INTENDED TO BENEFIT THE POOR AND UNDERSERVED, INCLUDING THOSE PERSONS WHO CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES OR ARE UNINSURED OR UNDERINSURED. HEALTH CARE SERVICES TO PATIENTS UNDER GOVERNMENT PROGRAMS, SUCH AS MEDICAID, ARE ALSO CONSIDERED PART OF THE BELLIN HEALTH BENEFITS PROVIDED TO THE COMMUNITY SINCE A SUBSTANTIAL PORTION OF SUCH SERVICES ARE REIMBURSED AT AMOUNTS LESS THAN COST.ActivityOrMissionDesc
Voting Members Governing Body23VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee4416TotalEmployeeCnt
Total Volunteers354TotalVolunteersCnt
Total Gross UBI$2,586,284TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,108,019PYContributionsGrantsAmt
CY Contributions Grants$13,409,509CYContributionsGrantsAmt
PY Program Service Revenue$559,196,425PYProgramServiceRevenueAmt
CY Program Service Revenue$566,552,003CYProgramServiceRevenueAmt
PY Investment Income$10,928,446PYInvestmentIncomeAmt
CY Investment Income$11,326,522CYInvestmentIncomeAmt
PY Other Revenue$8,883,002PYOtherRevenueAmt
CY Other Revenue$15,268,701CYOtherRevenueAmt
PY Total Revenue$580,115,892PYTotalRevenueAmt
CY Total Revenue$606,556,735CYTotalRevenueAmt
PY Grants And Similar Paid$779,584PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$686,264CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$301,014,013PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$322,933,154CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$230,442,314PYOtherExpensesAmt
CY Other Expenses$235,799,424CYOtherExpensesAmt
PY Total Expenses$532,235,911PYTotalExpensesAmt
CY Total Expenses$559,418,842CYTotalExpensesAmt
PY Revenues Less Expenses$47,879,981PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$47,137,893CYRevenuesLessExpensesAmt
Total Assets BOY$689,223,217TotalAssetsBOYAmt
Total Assets EOY$753,402,442TotalAssetsEOYAmt
Total Liabilities BOY$229,534,525TotalLiabilitiesBOYAmt
Total Liabilities EOY$247,167,372TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$459,688,692NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$506,235,070NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionBELLIN HEALTH IS A COMMUNITY-OWNED NOT-FOR-PROFIT ORGANIZATION RESPONSIBLE FOR IMPROVING THE HEALTH AND WELLBEING OF PEOPLE LIVING IN NORTHEAST WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN, AND ALL OTHERS WE SERVE. WE CARRY OUT THIS RESPONSIBILITY THROUGH INDIVIDUALIZED CARE EXCELLENCE, COMMUNITY HEALTH IMPROVEMENT, AND EQUITABLE HEALTHCARE FINANCING PLANS ALL DESIGNED TO POSITIVELY IMPACT HEALTH AND WELLBEING. WE ARE STEADFAST IN OUR COMMITMENT TO PROVIDING COMPASSIONATE, SAFE, AND COORDINATED CARE THAT IS ACCESSIBLE AND AFFORDABLE FOR EVERYONE. WE BUILD TRUSTED RELATIONSHIPS AND ADVANCE TRUE COLLABORATION, FUELING OUR DESIRE TO CONSTANTLY IMPROVE AND INNOVATE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$469,795,576ExpenseAmt
Grant$686,264GrantAmt
Revenue$577,206,208RevenueAmt
DescTHE HOSPITAL PROVIDES ACUTE HOSPITAL CARE TO RESIDENTS OF NORTHEASTERN WISCONSIN. DURING FISCAL YEAR 2020 35,357 INPATIENT DAYS WERE PROVIDED (32,396 ADULTS AND PEDIATRICS), AS COMPARED TO 33,562 (30,736 ADULTS AND PEDIATRICS) IN FISCAL YEAR 2019. THE NUMBER OF OUTPATIENTS REGISTERED FOR 2020 AND 2019 WERE 232,070 AND 254,357, RESPECTIVELY. BELLIN MEMORIAL HOSPITAL ALSO PROVIDED 939,032 (AS COMPARED TO 920,862 IN 2019) PHYSICIAN CLINIC VISITS THROUGH BELLIN MEDICAL AND SPECIALTY GROUPS.Desc
Total Program Service Expenses$469,795,576TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document339IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee4416EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtYes (1)SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members23GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JAMES DIETSCHE EPV-CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9204457260PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1744 S WEBSTER AVEAddressLine1Txt
CityGREEN BAYCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54301ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerInd
DAVID STAMPFL MD
PHYSICIAN40.00Yes (X)$1,532,485$0$41,515
GEORGE KERWIN - TERMED
FORMER CEO50.00$1,531,063$0$36,139Yes (X)
PATRICK MCKENZIE MD
PHYSICIAN40.00Yes (X)$1,193,851$0$39,629
JAMES SPEARS MD
PHYSICIAN40.00Yes (X)$1,165,488$0$32,716
ROBERT ANDERSON MD
PHYSICIAN40.00Yes (X)$1,137,269$0$38,353
TIMOTHY ROARTY MD
PHYSICIAN40.00Yes (X)$1,036,728$0$34,986
CHRISTINE WOLESKE
PRESIDENT/CEO50.00$1,028,581$0$170,215Yes (X)Yes (X)
STEVEN GERNDT MD
BOARD MEMBER/PRESIDENT MEDICAL STAFF50.00$729,797$0$31,287Yes (X)
JENNIFER LYNCH MD
BOARD MEMBER/PRESIDENT BELLIN SPECIALTY GROUP50.00$743,950$0$14,571Yes (X)
JAMES DIETSCHE
EVP-CFO50.00$518,817$0$81,453Yes (X)
ROBERT MEAD MD
BOARD MEMBER/PAST PRESIDENT MED50.00$319,156$0$38,188Yes (X)
WILLIAM WITTMAN MD
BOARD MEMBER/BMG PHYSIAN50.00$240,610$0$30,404Yes (X)
SABINA SINGH MD
BOARD MEMBER/PRESIDENT BEL50.00$247,845$0$20,622Yes (X)
MARK RINGWELSKI MD - TERMED
BOARD MEMBER/PRESIDENT BEL50.00$135,126$0$16,581Yes (X)
PAUL CASEY MD - TERMED
BOARD MEMBER/PRESIDENT MED50.00$27,961$0$0Yes (X)
TERRY FULWILER
BOARD CHAIR0.50$0$0$0Yes (X)Yes (X)
JOHN DYKEMA
VICE-CHAIR0.50$0$0$0Yes (X)Yes (X)
MARK MCMULLEN
BOARD SECRETARY0.50$0$0$0Yes (X)Yes (X)
ELL LEE DDS
TREASURER0.50$0$0$0Yes (X)Yes (X)
NANCY ARMBRUST
BOARD MEMBER0.50$0$0$0Yes (X)
G CORT CONDON
BOARD MEMBER0.50$0$0$0Yes (X)
DANIEL GULLING - TERMED
BOARD MEMBER0.50$0$0$0Yes (X)
FRED SCHMIDT MD
BOARD MEMBER0.50$0$0$0Yes (X)
DANIEL ARIENS
BOARD MEMBER0.50$0$0$0Yes (X)
JOHN JONES
BOARD MEMBER0.50$0$0$0Yes (X)
SUSAN FINCO
BOARD MEMBER0.50$0$0$0Yes (X)
MICHAEL HADDAD
BOARD MEMBER0.50$0$0$0Yes (X)
ROBERT CLAUSEN
BOARD MEMBER0.50$0$0$0Yes (X)
KARL SCHMIDT
BOARD MEMBER0.50$0$0$0Yes (X)
BARB GILLING
BOARD MEMBER0.50$0$0$0Yes (X)
BILL BOHN
BOARD MEMBER0.50$0$0$0Yes (X)
JAMIE SPITZER
BOARD MEMBER0.50$0$0$0Yes (X)
SAIED ASSEF MD
BOARD MEMBER/PHYSICIAN DIRECTOR50.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$11,588,727TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$626,659TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K432IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
APOGEE MEDICAL MANAGEMENT
15059 N SCOTTSDALE RD STE 600SCOTTSDALEAZ85254CONTRACTED PHYSICIAN/MANAGEMENT SERVICES$3,604,369
MAYO COLLABORATIVE SERVICES
200 1ST ST SWROCHESTERMN55905LAB SERVICES$2,634,822
NORDIC CONSULTING PARTNERS
2601 BELTLINE HWY STE 600MADISONWI53713IT STAFFING AND CONSULTING SERVICES$2,093,021
IEI GENERAL CONTRACTORS
1725 MIDWAY ROADDE PEREWI54115CONSTRUCTION SERVICES$2,040,435
AMERIEBO LLC
1851 S ALVERNO ROADMANITOWOCWI54220BILLING/COLLECTION SERVICES$1,901,119
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K73CntrctRcvdGreaterThan100KCnt
Related Organizations$698,410RelatedOrganizationsAmt
Government Grants$12,468,643GovernmentGrantsAmt
All Other Contributions$242,456AllOtherContributionsAmt
Total Contributions$13,409,509TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE621500$553,185,212$551,013,828$2,171,384
CONTRACTED SERVICES621110$3,580,537$3,580,537
ACO INCENTIVE621110$3,443,214$3,443,214
RENT FROM AFFILIATES621110$2,783,492$2,783,492
MISCELLANEOUS621110$1,748,601$1,748,601

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,810,947TotalRevenueColumnAmt
Related Or Exempt Func Income$44,519RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$414,900UnrelatedBusinessRevenueAmt
Exclusion$1,351,528ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$566,552,003TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,797,343TotalRevenueColumnAmt
Exclusion$6,797,343ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,834,182RealAmt
Personal$47,897PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,157,498RealAmt
Personal$47,897PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$676,684RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$676,684TotalRevenueColumnAmt
Exclusion$676,684ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$4,711,521SecuritiesAmt
Other$22,751OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$205,093OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$4,711,521SecuritiesAmt
Other-$182,342OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,529,179TotalRevenueColumnAmt
Exclusion$4,529,179ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
BOSC K-1 INCOME900099$6,953,503$6,953,503
EHR INCENTIVE621110$4,051,060$4,051,060
LOSS FROM HEALTHCARE AFFILIATES900099$3,587,454$3,587,454
FieldValueIRS element (for citing)
Other Revenue Total$14,592,017OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$606,556,735TotalRevenueColumnAmt
Related Or Exempt Func Income$577,206,208RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$2,586,284UnrelatedBusinessRevenueAmt
Exclusion$13,354,734ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$686,264TotalAmt
Program Services$686,264ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$4,216,156TotalAmt
Program Services$2,568,136ProgramServicesAmt
Management And General$1,648,020ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$256,271,848TotalAmt
Program Services$222,678,433ProgramServicesAmt
Management And General$33,593,415ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$11,079,238TotalAmt
Program Services$9,553,375ProgramServicesAmt
Management And General$1,525,863ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$35,306,440TotalAmt
Program Services$30,312,495ProgramServicesAmt
Management And General$4,993,945ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$16,059,472TotalAmt
Program Services$13,963,263ProgramServicesAmt
Management And General$2,096,209ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$893,334TotalAmt
Program Services$893,334ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$857,677TotalAmt
Management And General$857,677ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,108,650TotalAmt
Management And General$1,108,650ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$438,414TotalAmt
Management And General$438,414ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$39,631,857TotalAmt
Program Services$32,955,896ProgramServicesAmt
Management And General$6,675,961ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$6,213,235TotalAmt
Program Services$21,946ProgramServicesAmt
Management And General$6,191,289ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$7,552,993TotalAmt
Program Services$3,398,103ProgramServicesAmt
Management And General$4,154,890ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$8,796,884TotalAmt
Program Services$4,337,267ProgramServicesAmt
Management And General$4,459,617ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$10,977,901TotalAmt
Program Services$10,379,586ProgramServicesAmt
Management And General$598,315ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$992,284TotalAmt
Program Services$705,737ProgramServicesAmt
Management And General$286,547ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,466,042TotalAmt
Program Services$600,171ProgramServicesAmt
Management And General$865,871ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$6,667,315TotalAmt
Program Services$704,474ProgramServicesAmt
Management And General$5,962,841ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$24,090,621TotalAmt
Program Services$16,874,502ProgramServicesAmt
Management And General$7,216,119ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,077,969TotalAmt
Program Services$404,118ProgramServicesAmt
Management And General$673,851ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$85,892,244$85,538,546$353,698
EQUIPMENT RENT/MAINT$13,894,886$10,996,272$2,898,614
BAD DEBTS$12,601,213$12,601,213
DUES/SUBSCRIPTIONS$10,165,897$7,734,279$2,431,618

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,480,008TotalAmt
Program Services$1,888,166ProgramServicesAmt
Management And General$591,842ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$559,418,842TotalAmt
Program Services$469,795,576ProgramServicesAmt
Management And General$89,623,266ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$17,077BOYAmt
EOY$17,230EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$148,955,240BOYAmt
EOY$187,655,201EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$72,720,587BOYAmt
EOY$75,475,297EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$33,986,977BOYAmt
EOY$29,113,453EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$5,768,606BOYAmt
EOY$7,679,094EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$6,695,875BOYAmt
EOY$3,280,278EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$435,613,114LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$234,790,878LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$191,342,693BOYAmt
EOY$200,822,236EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$196,879,307BOYAmt
EOY$211,699,500EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$11,491,085BOYAmt
EOY$15,068,245EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$3,124,985BOYAmt
EOY$2,159,664EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$18,240,785BOYAmt
EOY$20,432,244EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$689,223,217BOYAmt
EOY$753,402,442EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$60,884,767BOYAmt
EOY$82,203,489EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$70,851BOYAmt
EOY$38,042EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$100,322,788BOYAmt
EOY$94,366,285EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$68,256,119BOYAmt
EOY$70,559,556EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$229,534,525BOYAmt
EOY$247,167,372EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$454,903,413BOYAmt
EOY$501,241,175EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,785,279BOYAmt
EOY$4,993,895EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$459,688,692BOYAmt
EOY$506,235,070EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$689,223,217BOYAmt
EOY$753,402,442EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$47,137,893ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$4,219,541NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$4,811,056OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$21,104OtherActivitiesAmt
Total Lobbying Expenditures$21,104TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationAHA AND WHA DUESExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,778,946BeginningYearBalanceAmt
Contributions$5,651ContributionsAmt
Investment Earnings Or Losses$46,602InvestmentEarningsOrLossesAmt
Other Expenditures$18,012OtherExpendituresAmt
End Year Balance$2,813,187EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,697,255BeginningYearBalanceAmt
Contributions$63,290ContributionsAmt
Investment Earnings Or Losses$27,788InvestmentEarningsOrLossesAmt
Other Expenditures$9,387OtherExpendituresAmt
End Year Balance$2,778,946EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,689,035BeginningYearBalanceAmt
Contributions$50ContributionsAmt
Investment Earnings Or Losses$32,052InvestmentEarningsOrLossesAmt
Other Expenditures$23,882OtherExpendituresAmt
End Year Balance$2,697,255EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,637,679BeginningYearBalanceAmt
Contributions$7,394ContributionsAmt
Investment Earnings Or Losses$56,750InvestmentEarningsOrLossesAmt
Other Expenditures$12,788OtherExpendituresAmt
End Year Balance$2,689,035EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,283,113BeginningYearBalanceAmt
Contributions$319,500ContributionsAmt
Investment Earnings Or Losses$45,890InvestmentEarningsOrLossesAmt
Other Expenditures$10,824OtherExpendituresAmt
End Year Balance$2,637,679EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.92140PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.07860TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,243,211OtherCostOrOtherBasisAmt
Book Value$10,243,211BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$192,081,035OtherCostOrOtherBasisAmt
Depreciation$77,249,055DepreciationAmt
Book Value$114,831,980BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,159,914OtherCostOrOtherBasisAmt
Depreciation$2,170,408DepreciationAmt
Book Value$989,506BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$216,236,723OtherCostOrOtherBasisAmt
Depreciation$155,371,415DepreciationAmt
Book Value$60,865,308BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,892,231OtherCostOrOtherBasisAmt
Book Value$13,892,231BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$200,822,236TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
DEFERRED COMPENSATION$14,455,735
NONCONTROLLING INTEREST OF CONSOLIDATED AFFILIATE$1,411,295
CAPITAL LEASE OBLIGATIONS$45,899,322
INTEREST RATE SWAP VALUATION$8,793,204
FieldValueIRS element (for citing)
Total Liability$70,559,556TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$603,058,364TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$4,219,541NetUnrealizedGainsInvstAmt
Other Revenue-$16,901,973OtherRevenueAmt
Revenue Not Reported-$12,682,432RevenueNotReportedAmt
Revenue Subtotal$615,740,796RevenueSubtotalAmt
Investment Expenses Not Incld$438,414InvestmentExpensesNotIncldAmt
Other Revenues Not Included-$9,622,475OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$9,184,061RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$606,556,735TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$556,318,363TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$10,351,850OtherExpensesIncludedAmt
Expenses Not Reported$10,351,850ExpensesNotReportedAmt
Expenses Subtotal$545,966,513ExpensesSubtotalAmt
Investment Expenses Not Incld2$438,414InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$13,013,915OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$13,452,329ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$559,418,842TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:ENDOWMENT FUNDS ARE INTENDED TO BE USED FOR HEALTH CARE SERVICES AND EMPLOYEE TRAINING AND DEVELOPMENT.
PART XI, LINE 2D - OTHER ADJUSTMENTS:GAIN ON SWAP AGREEMENT -1,171,684. NON-CONTROLLING INTEREST -3,129,076. PROVISION FOR BAD DEBTS -12,601,213.
PART XI, LINE 4B - OTHER ADJUSTMENTS:TRANSFER FROM FOUNDATION 698,410. HOSPITAL SUPPLIES 30,965. RENTAL EXPENSES -1,205,395. RENT FROM AFFILIATES 2,783,492. BOSC EXPENSES -11,929,947.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES 1,205,395. RENT FROM AFFILIATES -2,783,492. BOSC EXPENSES 11,929,947.
PART XII, LINE 4B - OTHER ADJUSTMENTS:REALLOCATION OF SUPPLIES EXPENSE TO 990T 30,965. EXPENSES PAID FOR BY FOUNDATION TRANSFERS 381,737. PROVISION FOR BAD DEBTS 12,601,213.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other220.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,948,754TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,948,754NetCommunityBenefitExpnsAmt
Total Expense0.00910TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$60,294,532TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$29,231,892DirectOffsettingRevenueAmt
Net Community Benefit Expns$31,062,640NetCommunityBenefitExpnsAmt
Total Expense0.05680TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$65,243,286TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$29,231,892DirectOffsettingRevenueAmt
Net Community Benefit Expns$36,011,394NetCommunityBenefitExpnsAmt
Total Expense0.06590TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,917,955TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,917,955NetCommunityBenefitExpnsAmt
Total Expense0.00900TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,570,135TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,570,135NetCommunityBenefitExpnsAmt
Total Expense0.00840TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,632,548TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,632,548NetCommunityBenefitExpnsAmt
Total Expense0.00300TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,120,638TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$11,120,638NetCommunityBenefitExpnsAmt
Total Expense0.02040TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$76,363,924TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$29,231,892DirectOffsettingRevenueAmt
Net Community Benefit Expns$47,132,032NetCommunityBenefitExpnsAmt
Total Expense0.08630TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$128,302TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$128,302NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$128,302TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$128,302NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$5,058,585BadDebtExpenseAmt
Reimbursed By Medicare$144,698,894ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$167,625,793CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$22,926,899MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line11 BELLIN ORTHOPEDIC SURGERY CENTER LLCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesORTHOPEDIC SURGERY CENTERPrimaryActivitiesTxt
Org Profit Or Ownership0.55000OrgProfitOrOwnershipPct
Physicians Profit Or Ownership0.45000PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BELLIN MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1744 S WEBSTER AVEAddressLine1Txt
CityGREEN BAYCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54305ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.BELLIN.ORGWebsiteAddressTxt
State License147StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1BELLIN MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted17CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION B, LINE 7DOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt17ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION B, LINE 7DStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care220.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://WWW.BELLIN.ORG/IMAGES/UPLOADS/BUSOF.001_-_FINANCIAL_ASSISTANCE.PDFFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://WWW.BELLIN.ORG/IMAGES/UPLOADS/COMMUNITY_CARE_APPLICATION.PDFFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://WWW.BELLIN.ORG/IMAGES/UPLOADS/PLAIN_LANGUAGE_SUMMARY_-_FINANCIAL_ASFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
BELLIN MEMORIAL HOSPITALPART V, SECTION B, LINE 5: THIS YEAR'S ASSESSMENT BUILT ON COLLABORATION, ACTIVELY SEEKING INPUT FROM A BROAD CROSS SECTION OF COMMUNITY STAKEHOLDERS WITH THE GOAL OF REACHING CONSENSUS ON PRIORITIES TO MUTUALLY FOCUS HUMAN, MATERIAL AND FINANCIAL RESOURCES ON. BELOW IS A LISTING OF PARTICIPANTS IN A CHNA SUMMIT IN WHICH HEALTH PRIORITIES WERE DETERMINED.-CITY OF GREEN BAY - PARKS & RECREATION-NORTHEASTERN WISCONSIN TECHNICAL COLLEGE-CITY OF DE PERE - HEALTH DEPARTMENT-BELLIN HEALTH-BROWN COUNTY PUBLIC HEALTH-ASHWAUBENON SCHOOLS-INTERN SCHOOL SOCIAL WORKER (HSSD)-WILLOW CREEK BEHAVIORAL HEALTH-HSHS ST VINCENT HOSPITAL/ ST MARY'S HOSPITAL-LIVE 54218-BELLIN PSYCHIATRIC CENTER-BROWN COUNTY BOARD-WIC-FAMILY & CHILDCARE RESOURCES OF NEW-AGING AND DISABILITY RESOURCE CENTER-BROWN COUNTY BOARD OF HEALTH-WI DHS DIVISION OF PUBLIC HEALTH-HOWARD SUAMICO SCHOOLS-CONNECTIONS FOR MENTAL WELLNESS-PULASKI COMMUNITY SCHOOLS-ST NORBERT COLLEGE-HSHS LIBERTAS TREATMENT CENTER-SHERMAN COUNSELING-UW EXTENSIONS-AIDS RESOURCE CENTER OF WISCONSIN (ARCW)-FOUNDATIONS-BOCE/ETC.-AURORA BEHAVIORAL HEALTH - UWGB-UNITED WAY - BROWN COUNTY-EX PRISONER OPPORTUNITIES-INTEGRATED COMMUNITY SOLUTIONS-OCONTO COUNTY PUBLIC HEALTH-RETIRED LAW ENFORCEMENT - DE PERE-BELLIN COLLEGE-BROWN COUNTY - CTC-UW GREEN BAY-ONEIDA NATION-BROWN COUNTY CHILD AND ADOLESCENT BEHAVIORAL HEALTH-PREVEA HEALTH-BROWN COUNTY HEALTH & HUMAN SERVICES-NEW COMMUNITY CLINIC-NEW COMMUNITY CLINIC & BROWN COUNTY BOARD OF HEALTH-GREEN BAY AREA PUBLIC SCHOOLS-CITY OF GREEN BAY - MAYOR-AURORA BAYCARE MEDICAL CENTER (ABMC)-ORAL HEALTH PARTNERSHIP-COMMUNITY VOLUNTEER-CITY OF DE PERE-JOSHUA - BC MENTAL HEALTH TASK FORCE - CONNECTIONS FOR MENTAL WELLNESS-DIOCESE OF GB CATHOLIC CHARITIES-BAY AREA COMMUNITY COUNCIL (BACC)-DARJUNE/EXPOTO ENSURE THAT THE NEEDS OF THESE GROUPS WERE ADEQUATELY REPRESENTED, WE INCLUDED REPRESENTATIVES FROM BROWN COUNTY HEALTH AND HUMAN SERVICES (PUBLIC HEALTH, AGING & DISABILITY RESOURCE CENTER, AND CHILD & FAMILY SERVICES); VARIOUS BROWN COUNTY DEPARTMENTS INCLUDING HEAD START, PROBATION & PAROLE, VICTIM/WITNESS SERVICES, VETERANS SERVICES; LOVE, INC.; BROWN COUNTY INTERFAITH ORGANIZATION; LOCAL SCHOOL DISTRICTS; BROWN COUNTY INTERFAITH; PARTNERS FOR COMMUNITY DEVELOPMENT; FAMILY RESOURCE CENTER OF BROWN COUNTY; SAFE HARBOR. THESE ORGANIZATIONS SERVE THE UNDER-RESOURCED IN OUR COMMUNITY, INCLUDING LOW-INCOME SENIORS, CHILDREN LIVING IN POVERTY, FAMILIES WHO STRUGGLE WITH SHELTER AND FOOD INSECURITY; VETERANS AND VICTIMS OF DOMESTIC VIOLENCE.
BELLIN MEMORIAL HOSPITALPART V, SECTION B, LINE 6A: AURORA BAYCARE MEDICAL CENTER (GREEN BAY) AND ST. MARY'S AND ST. VINCENT HOSPITALS (HSHS, GREEN BAY)
BELLIN MEMORIAL HOSPITALPART V, SECTION B, LINE 6B: BROWN COUNTY HEALTH DEPARTMENT, CITY OF DE PERE HEALTH DEPARTMENT, AND BROWN COUNTY UNITED WAY.
BELLIN MEMORIAL HOSPITALPART V, SECTION B, LINE 7D: FULL URL FOR PART V, SECTION B, LINE 7A:HTTPS://WWW.BELLIN.ORG/IMAGES/UPLOADS/BROWN_COUNTY-FY2018_CHNA_EDITS_04_10_FULL URL FOR PART V, SECTION B, LINE 10A:HTTPS://WWW.BELLIN.ORG/IMAGES/UPLOADS/BROWN_COUNTY_FY2018_IMPLEMENTATION_PL
BELLIN MEMORIAL HOSPITALPART V, SECTION B, LINE 11: THE MOST RECENT CHNA IDENTIFIED COMMUNITY NEEDS FOR FISCAL YEARS 2018 THROUGH 2020. THE NEEDS IDENTIFIED ARE: MENTAL HEALTH, PHYSICAL ACTIVITY, OBESITY, AND NUTRITION, AND HEALTH INEQUALITY. BELLIN REPRESENTATIVES LEAD THE INITIATIVES. A SUMMARY OF HOW BELLIN HAS BEEN ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA IS AS FOLLOWS:MENTAL HEALTH: LONG-TERM PERFORMANCE INDICATORS: BY JULY 2020, THE AVERAGE NUMBER OF POOR MENTAL HEALTH DAYS PER 30 DAYS, AS REPORTED BY COUNTY RESIDENTS, WILL DECREASE FROM 3.4 TO 3.2. STRATEGY ONE: SCREENING TOOL ASSESSMENT AND BEST PRACTICE IDENTIFICATION BELLIN HEALTH WILL WORK COLLABORATIVELY WITH THE BROWN COUNTY HEALTH DEPARTMENT AND MENTAL HEALTH TASK FORCE TO: -ASSIST IN COMPLETING AN INVENTORY OF CURRENT BEHAVIORAL HEALTH SCREENING TOOLS USED ACROSS SETTINGS. -ASSIST IN COMPLETING AN INVENTORY OF CURRENT SUICIDE RISK SCREENING TOOLS USED ACROSS SETTINGS (CONSIDER COLLABORATION WITH THE BROWN COUNTY COALITION FOR SUICIDE PREVENTION ON THIS ACTIVITY). -IDENTIFY BEST PRACTICE BEHAVIORAL HEALTH SCREENING TOOLS AND DEVELOP RECOMMENDATIONS FOR TOOLS USED IN VARIOUS COMMUNITY SETTINGS. -IDENTIFY BEST PRACTICE SUICIDE RISK SCREENING TOOLS AND DEVELOP RECOMMENDATIONS FOR TOOLS USED IN VARIOUS COMMUNITY SETTINGS. STRATEGY TWO: ""NO WRONG DOOR"" ACCESS PLATFORM FOR MENTAL HEALTH TREATMENT AND PROVIDERS BELLIN HEALTH WILL WORK COLLABORATIVELY WITH THE BROWN COUNTY HEALTH DEPARTMENT AND MENTAL HEALTH TASK FORCE TO: -IMPLEMENT TRILOGY NETWORK OF CARE IN COLLABORATION WITH NEW CONNECTIONS -WORK WITH PRIMARY CARE PROVIDERS TO IDENTIFY EDUCATION NEEDS AND STRENGTHEN PRIMARY CARE AS THE ENTRY POINT TO ""RIGHT CARE, RIGHT PERSON, RIGHT TIME"" MENTAL HEALTH TREATMENT. -INVESTIGATE AND IMPLEMENT A ""NO WRONG DOOR"" REFERRAL PROCESS BETWEEN COMMUNITY AGENCIES TO GUARANTEE THE RIGHT ACCESS AT THE RIGHT TIME. STRATEGY THREE: DEVELOP A NETWORK OF PEER SUPPORT, INCREASING AVAILABILITY OF IMMEDIATE RESOURCES TO COMMUNITY BELLIN HEALTH WILL WORK COLLABORATIVELY WITH THE BROWN COUNTY HEALTH DEPARTMENT AND MENTAL HEALTH TASK FORCE TO: -COMPLETE AN INVENTORY OF CURRENT MENTAL HEALTH PEER SUPPORT RESOURCES AVAILABLE IN THE COMMUNITY. -IDENTIFY EDUCATIONAL/TRAINING PROGRAMS AVAILABLE TO THOSE INTERESTED IN PROVIDING PEER SUPPORT IN THE COMMUNITY (E.G. QPR, MENTAL HEALTH FIRST AID, ETC.). -DEVELOP A PEER SUPPORT NETWORK, IMPLEMENT SERVICES AND PROVIDE RESOURCE CONTACTS TO COMMUNITY ORGANIZATIONS AND AGENCIES. PHYSICAL ACTIVITY, OBESITY, AND NUTRITION:LONG-TERM PERFORMANCE INDICATORS: BY 2020, INCREASE NUMBER OF INDIVIDUALS WITH A HEALTHY WEIGHT BY THREE PERCENT, AS EVIDENCED BY AN INCREASE IN THE NUMBER OF COMMUNITY MEMBERS WITH A BMI UNDER 30. (BASELINE MEASURE: 72 PERCENT AT HEALTHY WEIGHT, BASED ON COUNTY HEALTH RANKINGS 2017- 2013 DATA).STRATEGY ONE: FOOD AS MEDICINE BELLIN HEALTH WILL WORK COLLABORATIVELY WITH THE BROWN COUNTY HEALTH DEPARTMENT TO IMPROVE EQUITABLE ACCESS TO HEALTHY FOOD, AND INCREASE THE PROPORTION OF BROWN COUNTY RESIDENTS WHO CONSUME THE RECOMMENDED NUMBER OF SERVINGS OF FRUITS AND VEGETABLES BY AT LEAST TWO PERCENT (SHORT TERM) AND FOUR PERCENT (LONG TERM) BY: -ESTABLISHING RELATIONSHIPS WITH VARIOUS COMMUNITY GROUPS AND OFFERING ASSISTANCE TO FACILITATE CHANGE OR MAINTENANCE FOR PROGRAMS THAT FOCUS ON CONSUMPTION OF HEALTHY FOODS -MONITORING HEALTHY FOOD DONATIONS AT SCOUTING FOR FOODS DRIVE -MAINTAINING AND PROMOTING FOOD DRIVE 5 TOOLKIT -MONITORING AND ENCOURAGING FOOD PANTRY INFRASTRUCTURE THAT PROMOTES HEALTHY FOOD CHOICES -INSTITUTE A PLATFORM OF HEALTHY SNACKS IN THE SCHOOL SYSTEM BY ELIMINATING CANDY, HIGH FAT SNACKS AND SODA FROM VENDING MACHINES AND CAFETERIAS -TRACKING THE RATIO OF ELIGIBILITY FOR EBT PROGRAM TO THOSE WHO USE THE DOUBLE YOUR BUCKS PROGRAM AT THE FARMER'S MARKET -BEN'S WISH PROGRAM THAT ASSISTS LOCAL COMMUNITIES IN FIGHTING FOOD INSECURITY ISSUES THROUGH FOOD DRIVE COLLECTION, WEEKEND BACKPACK PROGRAM AND EDUCATIONAL ACTIVITIES. STRATEGY TWO: MOVEMENT AS MEDICINE BELLIN HEALTH WILL WORK COLLABORATIVELY WITH THE BROWN COUNTY HEALTH DEPARTMENT TO DECREASE PHYSICAL INACTIVITY (SHORT-TERM BY TWO PERCENT, LONG-TERM BY FOUR PERCENT) THROUGH EMPOWERING COMMUNITY MEMBERS TO USE ACTIVE MEANS OF TRANSPORT/MOVEMENT BY PARTNERING WITH THE GREATER GREEN BAY ACTIVE COMMUNITY ALLIANCE. ENCOURAGE BROWN COUNTY RESIDENTS TO UTILIZE COMMUNITY RESOURCES (E.G. WALKING/BIKING TRAILS, FITNESS CENTERS, ETC) AND FACILITATE CAMPAIGN(S) THAT PROMOTE(S) HEALTHY LIFESTYLES THROUGH SAFE AND AFFORDABLE MODES OF PHYSICAL ACTIVITY (AS MEASURED BY A DECREASE IN PHYSICAL INACTIVITY) BY STRUCTURING THE WORK AROUND THE THREE ES (ENGINEERING, EDUCATION, ENFORCEMENT). TOGETHER, WE WILL ACCOMPLISH THIS BY: -INVENTORYING EXISTING INITIATIVES THAT ARE IN ALIGNMENT WITH THIS OBJECTIVE. -PARTNERING WITH THE GREATER GREEN BAY ACTIVE COMMUNITY ALLIANCE TO CREATE A MORE ACTIVE AND CONNECTED COMMUNITY. -DEVELOPING AN EDUCATIONAL STRATEGY USING THE THREE ES IN PARTNERSHIP WITH THE GREATER GREEN BAY ACTIVE COMMUNITY ALLIANCE. -MONITORING UTILIZATION TRENDS OF ACTIVE DESIGN AND INFRASTRUCTURE TO IDENTIFY GAPS AND OPPORTUNITIES TO IMPROVE. STRATEGY THREE: CULTURE CHANGE: BELLIN HEALTH WILL WORK COLLABORATIVELY WITH THE BROWN COUNTY HEALTH DEPARTMENT TO LINK LIFE STUDY DATA, CHIP AND THE GROW PROJECT TOGETHER TO COLLABORATE ON COMMUNITY INITIATIVES. TOGETHER WE WILL CREATE A COMMUNITY DRIVEN BY MULTI-SECTORED PARTNERSHIPS SUPPORTIVE OF CULTURAL WELL-BEING THAT IMPROVES THE HEALTH OF BROWN COUNTY BY: -CONVENING MEETINGS WITH LEADERSHIP FROM LIFE STUDY, CHIP AND THE GROW PROJECT. -TESTING A COMMUNITY EDUCATION PLATFORM SUPPORTING THE CONNECTION BETWEEN NUTRITION, MOVEMENT AND HEALTH STATUS. -ENGAGING AND EMPOWERING THE GROWTH AND DEVELOPMENT OF RELATIONSHIPS BETWEEN AGENCIES IN THE FOOD-RELATED AND WELL-BEING SECTORS. -ADOPTING HEALTHFUL HOSPITAL FOOD AMERICAN MEDICAL ASSOCIATION RESOLUTION 406.HEALTH EQUALITY:IN ADDITION TO THE THREE COMMUNITY TEAMS, BELLIN IS HAS AN INTERNAL TEAM FOCUSED ON ADDRESSING HEALTH EQUITY. PRIMARY DRIVERS IN THIS WORK INCLUDE: LEADERSHIP AND ADVOCACY AS HEALTHCARE LEADERS FOR HEALTH EQUITY, ORGANIZATION FOCUS TO ADDRESS OPPORTUNITIES FOR HEALTH CARE EQUITY AND PARTNERSHIPS WITH THE KEY STAKEHOLDERS AND COMMUNITIES. ONE OF THE KEY PROJECT THAT THIS TEAM WILL FOCUS ON US THE COLLECTION AND USE OF REAL (RACE, ETHNICITY AND LANGUAGE) DATA. SOME ADDITIONAL PROJECTS THAT THE TEAM HAS PRIORITIZED FALL UNDER THE SECONDARY DRIVERS OF DEVELOPING A RECRUITMENT AND RETENTION STRATEGY TO EVOLVE THE WORKFORCE TO REFLECT THE COMMUNITY WE LIVE IN, AND THE QUALITATIVE AND QUANTITATIVE UNDERSTANDING OF THE POPULATIONS WE SERVE BY ADDRESSING THE SOCIAL DETERMINATES OF HEALTH. NEXT STEPS THE IMPLEMENTATION PLAN OUTLINES A THREE-YEAR COMMUNITY HEALTH IMPROVEMENT PROCESS. ANNUALLY, THE HOSPITAL WILL: -REVIEW THE IMPLEMENTATION PLAN AND UPDATE STRATEGIES FOR THE FOLLOWING FISCAL YEAR -SET AND TRACK ANNUAL PERFORMANCE INDICATORS FOR EACH IMPLEMENTATION STRATEGY -TRACK PROGRESS TOWARD MID TERM PERFORMANCE INDICATORS -REPORT PROGRESS TOWARD THE PERFORMANCE INDICATORS TO THE HOSPITAL BOARD, COMMUNITY BENEFIT ADVISORY COMMITTEE"
BELLIN MEMORIAL HOSPITALPART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY INCLUDES FACTORS AS: HOMELESS, DECEASED WITH NO KNOWN ESTATE, APPROVED COURT BANKRUPTCY, PAYMENT ASSISTANCE RANK ORDER SCORE, ELIGIBLE FOR STATE OF WI FOOD SHARE PROGRAM.
FieldValueIRS element (for citing)
Facility35FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (35 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - THE CANCER TEAM OF BELLIN HEALTH
1580 COMMANCHE AVEGREEN BAYWI54313PROVIDER CLINIC SITE
2 - FAMILY MEDICAL CENTER ASHWAUBENON
1630 COMMANCHE AVEGREEN BAYWI54313PROVIDER CLINIC SITE
3 - BELLIN HEALTH NEPHROLOGY
2020 RIVERSIDE DR SUITE 200GREEN BAYWI54301PROVIDER CLINIC SITE
4 - BELLIN HEALTH TITLETOWN SPORTS MEDICINE
1970 S RIDGE RDGREEN BAYWI54304PROVIDER CLINIC SITE
5 - BELLIN HEALTH GENERATIONS
704 S WEBSTER AVE SUITE 300GREEN BAYWI54301PROVIDER CLINIC SITE
6 - CARDIOLOGY ASSOCIATES OF BELLIN HEALTH
744 S WEBSTER AVEGREEN BAYWI54301HOSPITAL BASED SITE
7 - BELLIN HEALTH SURGICAL ASSOCIATES
720 S VAN BUREN ST SUITE 201GREEN BAYWI54301PROVIDER CLINIC SITE
8 - BELLIN HEALTH IRON MOUNTAIN
440 WOODWARD AVEIRON MOUNTAINMI49801PROVIDER CLINIC SITE
9 - FAMILY MEDICAL CENTER DE PERE EAST
555 REDBIRD CIRCLEDE PEREWI54115PROVIDER CLINIC SITE
10 - FAMILY MEDICAL CENTER BELLEVUE
3263 EATON RDGREEN BAYWI543116830PROVIDER CLINIC SITE
11 - GASTROENTEROLOGY ASSOCIATES OF GREEN BAY
725 S WEBSTER AVEGREEN BAYWI54301PROVIDER CLINIC SITE
12 - FAMILY MEDICAL CENTER HOWARD
2714 RIVERVIEWGREEN BAYWI54313PROVIDER CLINIC SITE
13 - NEUROLOGY CONSULTANTS OF BELLIN HEALTH
725 S WEBSTER AVEGREEN BAYWI54301PROVIDER CLINIC SITE
14 - FAMILY MEDICAL CENTER GREEN BAY
704 S WEBSTER AVEGREEN BAYWI54301PROVIDER CLINIC SITE
15 - BELLIN HEALTH CARDIOVASCULAR & THORACIC
720 S VAN BUREN ST SUITE 303GREEN BAYWI54301PROVIDER CLINIC SITE
16 - BELLIN HEALTH ESCANABA
610 S LINCOLN ROADESCANABAMI49829PROVIDER CLINIC SITE
17 - FAMILY MEDICAL CENTER DE PERE WEST
1800 LAWRENCE DRDE PEREWI54115PROVIDER CLINIC SITE
18 - BELLIN HEALTH OCONTO FALLS
107 E HIGHLAND DROCONTO FALLSWI54154PROVIDER CLINIC SITE
19 - FAMILY MEDICAL CENTER KEWAUNEE
575 - 4TH STREETKEWAUNEEWI54216PROVIDER CLINIC SITE
20 - FAMILY MEDICAL CENTER ALGOMA
831 PARKER AVEALGOMAWI54201PROVIDER CLINIC SITE
21 - FAMILY MEDICAL CENTER BRILLION
964 W RYAN ST SUITE BBRILLIONWI54110PROVIDER CLINIC SITE
22 - BELLIN HEALTH ASTHMA & ALLERGY
519 S MONROE AVENUEGREEN BAYWI54301PROVIDER CLINIC SITE
23 - BELLIN HEALTH ASTHMA & ALLERGY - NEENAH
1524 COMMERCIAL ST STE 2NNEENAHWI54957PROVIDER CLINIC SITE
24 - FAMILY MEDICAL CENTER MANITOWOC
3415 CUSTER ST SUITE DMANITOWOCWI54221PROVIDER CLINIC SITE
25 - BELLIN HEALTH ENDOCRINOLOGY
704 S WEBSTER AVE SUITE 501GREEN BAYWI54301PROVIDER CLINIC SITE
26 - FAMILY MEDICAL CENTER DENMARK
595 COUNTY ROAD RDENMARKWI54208PROVIDER CLINIC SITE
27 - FAMILY MEDICAL CENTER PULASKI
723 S WISCONSIN STPULASKIWI541620109PROVIDER CLINIC SITE
28 - FAMILY MEDICAL CENTER SEYMOUR
405 COMMERCIAL STSEYMOURWI54165PROVIDER CLINIC SITE
29 - FAMILY MEDICAL CENTER WRIGHTSTOWN
555 QUALITY CTWRIGHTSTOWNWI54180PROVIDER CLINIC SITE
30 - FAMILY MEDICAL CENTER LUXEMBURG
140 B SCHOOL CREEK TRAILLUXEMBURGWI54217PROVIDER CLINIC SITE
31 - FAMILY MEDICAL CENTER STURGEON BAY
311 N 3RD AVESTURGEON BAYWI54235PROVIDER CLINIC SITE
32 - FAMILY MEDICAL CENTER SURING
307 MANOR DRSURINGWI54174PROVIDER CLINIC SITE
33 - FAMILY MEDICAL CENTER BONDUEL
401 W MILL STBONDUELWI54107PROVIDER CLINIC SITE
34 - BELLIN HEALTH FASTCARE - GREEN BAY EAST
1976 LIME KILN RDGREEN BAYWI54311CONVENIENT CARE CENTER
35 - BELLIN HEALTH FASTCARE - GREEN BAY WEST
2015 SHAWANO AVEGREEN BAYWI54303CONVENIENT CARE CENTER

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 6A:BELLIN MEMORIAL HOSPITAL IN INCLUDED IN THE BELLIN HEALTH SYSTEMS, INC. COMMUNITY BENEFIT REPORT.
PART I, LINE 7:AMOUNTS ARE CALCULATED BASED ON COST TO CHARGE RATIOS AND AMOUNTS PER THE FINANCIAL STATEMENTS.
PART I, LN 7 COL(F):BAD DEBT EXPENSE OF $12,601,213 INCLUDED ON FORM 990, PART IX, LINE 25 WAS EXCLUDED FROM THE DENOMINATOR PER INSTRUCTIONS WHEN CALCULATING THE PERCENT TOTAL EXPENSES ON SCHEDULE H.
PART II, COMMUNITY BUILDING ACTIVITIES:COMMUNITY BUILDING ACTIVITIES FOCUS ON SOCIAL CONDITIONS THAT CONTRIBUTE TO HEALTH PROBLEMS, SUCH AS HOMELESSNESS, POVERTY, AND OTHER LIVING CONDITIONS AFFECTING THE QUALITY OF LIFE. THESE RANGE FROM DEVELOPING COMMUNITY LEADERS, DISASTER READINESS, AND SUPPORT OF LOCAL ECONOMIC DEVELOPMENT, TO HEALTH IMPROVEMENT ADVOCACY. BELLIN MEMORIAL HOSPITAL IS ACTIVE IN THE GREEN BAY PUBLIC SCHOOLS WITH OUR THRIVE PROGRAM THAT ASSISTS IN SETTING AND MEETING HEALTH AND WELLNESS GOALS FOR STUDENTS IN THIS SCHOOL SYSTEM. BELLIN ALSO HOLDS AN ANNUAL BELLIN RUN/WALK 10K EVENT EACH YEAR WITH OVER 13,000 PARTICIPANTS OF ALL AGES LEARNING FIRST HAND THE VALUE OF EXERCISE IN DAILY LIFE.
PART III, LINE 2:THE BAD DEBT EXPENSE AT COST IS CALCULATED BASED ON THE COST TO CHARGE RATIOS.
PART III, LINE 3:THE HOSPITAL UTILIZES HFMA #15 THEREFORE NONE OF THE BAD DEBT WOULD BE DEEMED CHARITY CARE.
PART III, LINE 4:THE ATTACHED FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC BAD DEBT EXPENSE FOOTNOTE. HOWEVER, THE SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES DESCRIBES THE HOSPITAL'S POLICY ON PAGE 16 OF THE FINANCIAL STATEMENTS. CONSISTENT WITH BELLIN HEALTH SYSTEMS' MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, BELLIN HEALTH SYSTEMS HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES (FOR EXAMPLE, COPAYS AND DEDUCTIBLES). THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS BELLIN HEALTH SYSTEMS EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. BELLIN HEALTH SYSTEMS' POLICY IS TO PROVIDE A 35% DISCOUNT FROM ESTABLISHED CHARGES TO UNINSURED PATIENTS. THIS POLICY DID NOT CHANGE IN 2020 AND 2019.
PART III, LINE 8:THE AMOUNTS REPORTED FOR MEDICARE WERE CALCULATED USING A COST TO CHARGE RATIO. THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT FOR THE FOLLOWING REASONS. IRS REV RUL 69-545 WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS STATES THAT IF A HOSPITAL SERVICES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. IN ADDITION, FOR-PROFIT HOSPITALS HAVE CARVED OUT HIGH-MARGIN SERVICES (I.E. ONCOLOGY, ORTHO, ETC) LEAVING GENERAL ACUTE CARE HOSPITALS WITH LOWER-MARGIN MEDICARE SERVICES. THIS MEANS THAT THE SHORTFALL IS NOT NECESSARILY FROM INEFFICIENT OPERATIONS. MEDICARE CAN BE THE LARGEST PAYOR AND HOSPITALS HAVE NO ABILITY TO DENY COVERAGE. THIS, IN TURN, IS A PROMOTION OF ACCESS TO HEALTHCARE SERVICES (A COMMUNITY BENEFIT). ALSO, ELDERLY PATIENTS ARE OFTEN UNDERSERVED AND EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES.
PART III, LINE 9B:FOR PATIENTS WHO CANNOT MEET THE EXPECTATIONS OF THE DEBT COLLECTION POLICY, THE ORGANIZATION OFFERS FINANCIAL ASSITANCE. THE ORGANIZATION WILL NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS BEFORE DETERMING WHETHER A GUARANTOR IS ELIGILBE FOR ASSISTANCE UNTER THE FINANCIAL ASSISTANCE POLICY. ALL PATIENTS ARE OFFERED A PLAIN LANGUAGE SUMMARY EXPLAINING THE FINANCIAL ASSISTANCE PROGRAM AS PART OF THE REGISTRATION PROCESS IN ADDITION, ALL STATEMENTS INCLUDE INFORMATION REGARDING FINANCIAL ASSISTANCE AVAILABILITY.
PART VI, LINE 2:IN FY2020, BELLIN MEMORIAL HOSPITAL CONTINUALLY ASSESSED THE HEALTHCARE NEEDS OF OUR COMMUNITIES, WITH A MAJOR AREA OF FOCUS ON COVID-19. THROUGH OUR PARTNERSHIP WITH PUBLIC HEALTH AND THE BEYOND HEALTH COMMUNITY COLLABORATIVE, EFFORTS WERE AIMED AT CREATING AND IMPLEMENTING COVID-19 INTERVENTIONS TO ADDRESS ACCESS TO HEALTHCARE, TESTING, AND PREVENTION MEASURES. INTENTIONAL EFFORTS WERE MADE BY BELLIN HEALTH TO UNDERSTAND AND ADDRESS THE BURDEN OF COVID-19 IN BROWN COUNTY SPECIFIC TO GROUPS IMPACTED BY INEQUITY AND HEALTH DISPARITIES IN THE COMMUNITY. INTERVENTIONS INCLUDED ONSITE TESTING AT LOCAL MEAT PACKING PLANTS, TO ADDRESS THE NEEDS OF ESSENTIAL WORKERS. ADDITIONAL COMMUNITY ASSESSMENT AND OUTREACH INCLUDED SAFE-AT-WORK AND SAFE-AT-SCHOOL ASSESSMENTS TO SUPPORT SAFE RETURN TO WORK AND SCHOOL EFFORTS IN PARTNERSHIP WITH EMPLOYERS AND SCHOOLS. LOCAL EMPLOYERS WERE SURVEYED THROUGHOUT FY2020 TO ASSESS AND ADDRESS HEALTHCARE NEEDS. COMMUNITY UPDATES AND EDUCATION WERE PROVIDED THROUGH VIRTUAL TOWNHALL SESSIONS. ADDITIONALLY, MONTHLY VIRTUAL SESSIONS WERE HELD TO ADDRESS MENTAL HEALTH TOPICS. DURING THIS TIME, BELLIN HEALTH TEAM MEMBERS CONTRIBUTED TO THE NEXT CHNA, WHILE CHIP WORKGROUPS MET VIRTUALLY TO WORK TOWARD SET GOALS.
PART VI, LINE 3:FINANCIAL COUNSELORS ADVISE PATIENTS OF ASSISTANCE PROGRAMS. A SERVICE CALLED HRS ERASE IS USED TO REVIEW SELF PAY ACCOUNTS FOR POSSIBLE COVERAGE THROUGH GOVERNMENT PROGRAMS.
PART VI, LINE 4:BELLIN MEMORIAL HOSPITAL SERVES NORTHEAST WISCONSIN AND UPPER MICHIGAN. OUR CURRENT PAYOR SUPPLEMENTAL INFORMATION MIX IS 46.2% MEDICARE AND 9.4% MEDICAID.
PART VI, LINE 5:A MAJORITY OF BELLIN MEMORIAL HOSPITALS GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN BELLIN MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEROF. IN ADDITION, BELLIN MEMORIAL HOSPITAL EXTENDS MEDICAL STAFF PRIVELEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR ALL OF ITS DEPARTMENTS. BELLIN MEMORIAL HOSPITAL APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, EDUCATION, AND FACILITIES.
PART VI, LINE 6:BELLIN HEALTH IS A COMMUNITY-OWNED NOT-FOR-PROFIT ORGANIZATION RESPONSIBLE FOR THE PHYSICAL AND EMOTIONAL HEALTH OF PEOPLE LIVING IN NORTHEAST WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN. DIRECTLY, AND IN PARTNERSHIP WITH COMMUNITIES, EMPLOYERS, SCHOOLS, AND GOVERNMENT OFFICIALS, WE GUIDE INDIVIDUALS AND FAMILIES IN THEIR LIFELONG JOURNEY TOWARD OPTIMAL HEALTH. WE ARE COMMITTED TO PROVIDING SAFE, RELIABLE, COST-EFFECTIVE TOTAL HEALTH SOLUTIONS WITH RESPECT AND COMPASSION. OUR INNOVATIVE WORK WILL IMPACT HEALTHCARE DELIVERY IN OUR REGION AS WELL AS THROUGHOUT THE WORLD.
PART VI, LINE 7, REPORTS FILED WITH STATESWI

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (26 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
ALTRUSA HOUSE
1116 E MASON STGREEN BAYWI54301391593989501(C)3$25,000COMMUNITY SPONSORSHIP
BAY LAKES COUNCIL
PO BOX 267APPLETONWI54912391184320501(C)3$5,000DONATION
CEREBRAL PALSY INC
2801 S WEBSTER AVEGREEN BAYWI54301390901265501(C)3$23,000CAPITAL CAMPAIGN - BUILDING EXPANSION
CURATIVE CONNECTIONS
2900 CURRY LNGREEN BAYWI54311390806435501(C)3$20,000DONATION
DOCTORS IN RECITAL INC
N9349 ABITZ LNDYCKESVILLEWI54217391516026501(C)3$7,500DONATION
DOWNTOWN GREEN BAY CHARITIES
130 E WALNUT STGREEN BAYWI54301391858389501(C)3$7,500FARMERS MARKET
ENCOMPASS EARLY EDUCATION & CARE
2589 S WEBSTER AVEGREEN BAYWI54301390824004501(C)3$35,000DONATION
FAMILY SERVICES
300 CROOKS STGREEN BAYWI54305390827320501(C)3$46,200DONATION
FOUNDATIONS HEALTH & WHOLENESS
1061 W MASON STGREEN BAYWI54303391047205501(C)3$5,000DONATION
GREATER GREEN BAY COMMUNITY FOUNDATION
310 W WALNUT ST SUITE 350GREEN BAYWI54303391699966501(C)3$51,000GREEN BAY NEIGHBORHOOD LEADERSHIP COUNCIL, ACHIEVE BROWN COUNTY
GREEN BAY AREA CHAMBER OF COMMERCE
300 N BROADWAY ST STE 3AGREEN BAYWI54303390318170501(C)3$27,500DONATION
GREEN BAY PUBLIC SCHOOLS
PO BOX 23387GREEN BAYWI543053387396002329GOVT - PUBLIC SCHOOL$50,000HEALTH & WELLNESS PROGRAM
HOWARD SUAMICO SCHOOL DISTRICT
2706 LINEVILLE RDGREEN BAYWI543137151396031599GOVT - PUBLIC SCHOOL$50,000ATHLETIC PROGRAMS - FIELD SURFACE
KIWANIS SKI CLUB
PO BOX 475IRON MOUNTAINMI49801383254313501(C)3$25,000DONATION
LUXEMBURG-CASCO SCHOOL DISTRICT
318 N MAIN STLUXEMBURGWI54217391087534GOVT - PUBLIC SCHOOL$5,000DONATION
MARCH OF DIMES
677 BAETEN RD STE 100GREEN BAYWI54304131846366501(C)3$5,000DONATION
MARINETTE MENOMINEE AREA COMMUNITY FOUNDATION
1101 11TH AVEMENOMINEEWI49858383264725501(C)3$5,000DONATION
NEW COMMUNITY CLINIC
622 BODART STREETGREEN BAYWI54301391200636501(C)3$50,000SUPPORT FREE COMMUNITY HEALTH CLINIC
UNIVERSITY OF WI - GREEN BAY
2420 NICOLET DRGREEN BAYWI54311391805963GOVT- STATE AGENCY$25,000MARK REINKE, MD MEMORIAL SCHOLARSHIP
UNIVERSITY OF WI - OSHKOSH
842 ALGOMA BLVDOSHKOSHWI54901391805963GOVT- STATE AGENCY$85,000SUPPORT ORGANIZATION'S ACTIVITIES
WRIGHTSTOWN SCHOOL DISTRICT
PO BOX 128WRIGHTSTOWNWI541800128391016208GOVT - PUBLIC SCHOOL$10,000DONATION
YWCA GREATER GREEN BAY
230 S MADISON STGREEN BAYWI54301390806277501(C)3$23,700DONATION
DOOR COUNTY ECONOMIC
185 E WALNUT STSTURGEON BAYWI54235391621905501(C)3$5,000DONATION
HOWE COMMUNITY RESOURCE CENTER
526 S MONROE AVEGREEN BAYWI54301391910410501(C)3$5,000DONATION
NEVILLE PUBLIC MUSEUM
PO BOX 325GREEN BAYWI54305930756332MUSEUM$10,000DONATION
UNIVERSITY OF WI - MADISON
1220 LINDEN DRMADISONWI53706391805963501(C)3$5,000DONATION
FieldValueIRS element (for citing)
Total501c3 Org25Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION REQUIRES A COMPREHENSIVE REQUEST OF THE GRANTEE TO PROVIDE RATIONALE FOR THE REQUEST. REQUIRED INFORMATION TO BE PROVIDED BY THE GRANTEE INCLUDES, TAX-EXEMPT STATUS, IDENTIFICATION OF USE OF RESOURCES AND FOLLOW UP INFORMATION AS TO THE UTILIZATION OF THE RESOURCES. THE ORGANIZATION REVIEWS EACH GRANTEE REQUEST IN RELATIONSHIP TO THE MISSION OF THE ORGANIZATION AND COMMUNITY SUPPORT. ALL REQUESTS REQUIRE APPROVAL BY SENIOR LEADERSHIP OF THE ORGANIZATION.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DAVID STAMPFL MD
PHYSICIAN$893,206$0$638,505$0$774$0$17,746$0$23,769$0$1,574,000$0$0$0
GEORGE KERWIN - TERMED
FORMER CEO$6,923$0$1,354,000$0$170,140$0$36,139$0$0$0$1,567,202$0$0$0
PATRICK MCKENZIE MD
PHYSICIAN$1,192,583$0$80$0$1,188$0$15,785$0$23,844$0$1,233,480$0$0$0
JAMES SPEARS MD
PHYSICIAN$717,094$0$447,206$0$1,188$0$13,640$0$19,076$0$1,198,204$0$0$0
ROBERT ANDERSON MD
PHYSICIAN$776,516$0$359,565$0$1,188$0$18,734$0$19,619$0$1,175,622$0$0$0
TIMOTHY ROARTY MD
PHYSICIAN$493,710$0$542,244$0$774$0$11,217$0$23,769$0$1,071,714$0$0$0
CHRISTINE WOLESKE
PRESIDENT/CEO$570,739$0$422,692$0$35,150$0$151,742$0$18,473$0$1,198,796$0$0$0
STEVEN GERNDT MD
BOARD MEMBER/PRESIDENT MEDICAL STAFF$396,768$0$332,255$0$774$0$13,711$0$17,576$0$761,084$0$0$0
JENNIFER LYNCH MD
BOARD MEMBER/PRESIDENT BELLIN SPECIA$549,994$0$193,686$0$270$0$13,291$0$1,280$0$758,521$0$0$0
JAMES DIETSCHE
EVP-CFO$428,323$0$90,080$0$414$0$57,862$0$23,591$0$600,270$0$0$0
ROBERT MEAD MD
BOARD MEMBER/PAST PRESIDENT MED$196,511$0$121,457$0$1,188$0$16,697$0$21,491$0$357,344$0$0$0
WILLIAM WITTMAN MD
BOARD MEMBER/BMG PHYSIAN$218,625$0$19,699$0$2,286$0$10,330$0$20,074$0$271,014$0$0$0
SABINA SINGH MD
BOARD MEMBER/PRESIDENT BEL$185,767$0$61,664$0$414$0$12,053$0$8,569$0$268,467$0$0$0
MARK RINGWELSKI MD - TERMED
BOARD MEMBER/PRESIDENT BEL$95,218$0$39,497$0$411$0$9,582$0$6,999$0$151,707$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ABELLIN MEMORIAL HOSPITAL PAYS FOR A PORTION OF MEMBERSHIP DUES AT A LOCAL COUNTRY CLUB FOR CHRISTINE WOLESKE IN ORDER TO HOLD VARIOUS EVENTS AT THE CLUB. THIS BENEFIT IS TREATED AS TAXABLE COMPENSATION.
PART I, LINE 4BTHE HOSPITAL HAS A DEFERRED COMPENSATION PLAN FOR SELECTED EXECUTIVES. THE PARTICIPANTS ARE CHRIS WOLESKE AND JAMES DIETSCHE.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
A39133785597712DLH72015-04-09$44,994,006REFUND AND LEGALLY DEFEASE000
WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
B3913378552011-11-23$12,944,000REFINANCING OF 2001 BONDS000
WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
C3913378552019-08-29$35,000,000FUNDING OF NICU EXPANSION PROJECT AND VARIOUS RENOVATION AND EQUIPMENT PURCH000
WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
D3913378552019-08-29$8,000,000FUNDING OF IT INFRASTRUCTURE000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndIn Reserve FundInReserveFundAmtCapital ExpendituresCapitalExpendituresAmt
A$2,685,000$44,994,006$528,236$44,465,77020090Yes (1)Yes (1)Yes (1)
B$1,290,000$12,944,000$79,8442001Yes (1)0Yes (1)Yes (1)
C$41,624,205$314,452000Yes (1)$25,949,079$15,360,674
D$8,351,848$74,748000Yes (1)$1,950,999$6,326,101

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndEngage Bond Counsel ContractsEngageBondCounselContractsIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0Yes (1)Yes (1)Yes (1)00.010000.01000Yes (1)0Yes (1)
B0Yes (1)Yes (1)Yes (1)00.010000.01000Yes (1)0Yes (1)
C0Yes (1)Yes (1)Yes (1)00.010000.01000Yes (1)0Yes (1)
D0Yes (1)Yes (1)Yes (1)00.010000.01000Yes (1)0Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueInd
AYes (1)0000Yes (1)
BYes (1)0000Yes (1)
C00000Yes (1)Yes (1)00
D00000Yes (1)Yes (1)00

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)
DYes (1)

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonSUSAN FINCOPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionOWNER OF LEONARD & FINCO COMMUNICATIONSRelationshipDescriptionTxt
Transaction$187,353TransactionAmt
TransactionPROVISION OF MARKETING SERVICESTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2SABINA SINGH, MARK MCMULLEN, AND TERRY FULWILER HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION HAS ONE CORPORATE MEMBER, BELLIN HEALTH SYSTEMS, INC.
FORM 990, PART VI, SECTION A, LINE 7ATHE CORPORATE MEMBER, BELLIN HEALTH SYSTEMS, INC. HAS THE POWER TO APPOINT BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7BTHE CORPORATE MEMBER, BELLIN HEALTH SYSTEMS, INC., HAS THE POWER TO APPROVE MAJOR EXPENDITURES AND LONG-TERM BORROWINGS.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS REVIEWED IN DETAIL BY SENIOR ADMINISTRATION AND IS PRESENTED TO THE EXECUTIVE COMMITTEE IN ITS ENTIRETY FOR A REVIEW OF THE DOCUMENT.
FORM 990, PART VI, SECTION B, LINE 12CEACH YEAR A CONFLICT OF INTEREST REQUEST DOCUMENT IS PROVIDED TO EACH BOARD MEMBER. ALL DOCUMENTS ARE PROVIDED BACK TO ADMINISTRATION AND REVIEWED. ALL EMPLOYEES ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AS PART OF ANNUAL MANDATORY EDUCATION. IF THERE IS A CONFLICT OF INTEREST, THE CORPORATE COMPLIANCE OFFICER AND CORPORATE COMPLIANCE COMMITTEE WHICH IS A COMMITTEE OF THE BOARD OF DIRECTORS IS NOTIFIED. THE CORPORATE COMPLIANCE OFFICER AND CORPORATE COMPLIANCE COMMITTEE ADDRESSES THE ISSUE.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION FOR THE CEO AND KEY EXECUTIVES ARE SET BY THE EXECUTIVE COMMITTEE OF THE BOARD SUPPORTED BY MARKET DATA FROM SURVEYS AND AN INDEPENDENT CONSULTANTS REPORT. THE COMPENSATION IS DETERMINED BY MEMBERS OF THE EXECUTIVE COMMITTEE WITHOUT CONFLICT AND IS DOCUMENTED. CEO COMPENSATION: CEO PRESENTS RESULTS OF PERFORMANCE OBJECTIVES TO THE EXECUTIVE COMMITTEE IN JANUARY OF EACH YEAR. THE CHAIR APPLIES A FORMULA TO THE RESULTS AND COMES UP WITH A RECOMMENDATION. THE CHAIR FACILITATES GETTING APPROVAL FROM OTHER MEMBERS OF THE EXECUTIVE COMMITTEE. SENIOR LEADERS: COMPENSATION FOR THOSE WHO REPORT TO THE CEO IS TAKEN TO THE EXECUTIVE COMMITTEE FOR DISCUSSION/APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION BELIEVES THE FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND POLICIES ARE THE PROPERTY OF THE ORGANIZATION AND ARE NOT AVAILABLE FOR PUBLIC INSPECTION.
FORM 990, PART XI, LINE 9:CHANGE IN INTEREST IN FOUNDATION -10,296. INTEREST RATE SWAP AGREEMENT -1,171,684. TRANSFER NET ASSETS TO BELLIN FOUNDATION -500,000. NON-CONTROLLING INTEREST IN CONSOLIDATED AFFILIATE -3,129,076.
FORM 990, PART XI, LINE 2B-2CBELLIN MEMORIAL HOSPITAL, INC. IS INCLUDED IN THE CONSOLIDATED AUDIT OF BELLIN HEALTH SYSTEMS, INC. THE BOARD OF DIRECTORS OF BELLIN HEALTH SYSTEMS, INC. ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT AUDITOR. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
LAKE MICHIGAN HEALTH SERVICES INC
744 SOUTH WEBSTER AVEGREEN BAYWI54305391512903SUPPORT PURPOSES OF BELLIN MEMORIAL HOSPITALWI501(C)(3)LINE 12B, IIBELLIN HEALTH SYSTEMS INCYes (1)
BELLIN COLLEGE INC
3201 EATON ROADGREEN BAYWI54311391620530NURSING COLLEGEWI501(C)(3)LINE 2BELLIN HEALTH SYSTEMS INCYes (1)
THE BELLIN HEALTH FOUNDATION INC
PO BOX 23400GREEN BAYWI54305391809171FOUNDATIONWI501(C)(3)LINE 7BELLIN HEALTH SYSTEMS INCYes (1)
BELLIN PSYCHIATRIC CENTER INC
PO BOX 23725GREEN BAYWI54305391657627PPSYCHIATRIC HOSPITALWI501(C)(3)LINE 3BELLIN HEALTH SYSTEMS INCYes (1)
OCONTO HOSPITAL & MEDICAL CENTER INC
PO BOX 357OCONTOWI54153061745397HOSPITALWI501(C)(3)LINE 3BELLIN MEMORIAL HOSPITAL INCYes (1)
BELLIN HEALTH SYSTEMS INC
744 SOUTH WEBSTER AVEGREEN BAYWI54305391512904SUPPORT OF HEALTHCARE ORGANIZATIONSWI501(C)(3)LINE 12B, II0N/A
UNITY LIMITED PARTNERSHIP
2366 OAK RIDGE CIRCLEDE PEREWI54115391750729HOSPICE, PALLIATIVE & BEREAVEMENT SERVICESWI501(C)(3)LINE 100N/A

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1BELLIN ORTHOPEDIC SURGERY CENTER LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12223 LIME KILN RDAddressLine1Txt
CityGREEN BAYCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54311ZIPCd
FieldValueIRS element (for citing)
EIN264677834EIN
Primary ActivitiesAMBULATORY ORTHOPEDIC SURGERYPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1BELLIN MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income$4,249,386ShareOfTotalIncomeAmt
Share Of EOY Assets$1,176,156ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
Ownership0.55000OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
BEL-REGIONAL HOME MEDICAL INC
617 S ROOSEVELTGREEN BAYWI54301391504766DURABLE MEDICAL EQUIPMENT, RETAIL PHARMACY, FITNESSWIN/ACYes (1)
BELLIN INVESTMENTS INC
PO BOX 23400GREEN BAYWI54305391564939OTHERWIN/ACYes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (17 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
OCONTO HOSPITAL & MEDICAL CENTER
J$2,760,893ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
O$6,551,522ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
D$10,328,117ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
S$52,800,784ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
L$6,066,479ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
D$1,914,376ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
D$26,300,000ACTUAL
BELLIN PSYCHIATRIC CENTER
J$56,012ACTUAL
BELLIN PSYCHIATRIC CENTER
D$10,519,143ACTUAL
BELLIN PSYCHIATRIC CENTER
D$1,922,699ACTUAL
BELLIN PSYCHIATRIC CENTER
S$15,500,000ACTUAL
BELLIN PSYCHIATRIC CENTER
Q$2,165,579ACTUAL
BELLIN HEALTH FOUNDATION
C$698,410ACTUAL
BELLIN HEALTH FOUNDATION
B$500,000ACTUAL
BELLIN HEALTH FOUNDATION
S$1,380,000ACTUAL
BELLIN HEALTH FOUNDATION
O$397,315ACTUAL
BELLIN HEALTH FOUNDATION
Q$784,275ACTUAL